Qualis Health has partnered with the Washington State Department of Labor & Industries (Washington L&I) to provide utilization review services for its Workers' Compensation Program. The success of this program depends on the collaborative relationship between providers, Washington L&I and Qualis Health. Qualis Health provides services to make sure eligible injured workers get the appropriate care where and when they need it.
Utilization reviews are conducted on a prospective, concurrent and/or retrospective basis employing Washington L&I's Medical Treatment Guidelines, if applicable; otherwise, Qualis Health applies InterQual criteria.
Qualis Health reviews inpatient admissions, a select list of outpatient procedures, specified advanced imaging studies and physical medicine services.
New Work Conditioning Questionnaires Effective July 6, 2015
Effective Monday, July 6, 2015, the Work Conditioning Questionnaire has been replaced by two new versions—one for faxing and one for web-based submissions.
You can also find these questionnaires on the Provider Resources page.
Transition to Qualis Health Provider Portal Effective January 2
As of January 2, 2015, we transitioned to the Qualis Health Provider Portal, a new platform for electronically submitting utilization management (UM) reviews. What this means for you:
If you accessed our old system (iEXCHANGE) via OneHealthPort, you don't need to register. Your user account(s) will simply be transitioned to the Qualis Health Provider Portal.
If you accessed our old system (iEXCHANGE) via a direct weblink, you must register for OneHealthPort and the Qualis Health Provider Portal. Go to the OneHealthPort website to complete both of these registrations.