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.
Updates to Knee Surgery Medical Treatment Guidelines
New MTGs will go into effect 8/1/16. Please see our notice and L&I treatment guidelines to learn about the upcoming changes.
Qualis Health Provider Portal User Guide Updated
January 22, 2016: The Qualis Health Provider Portal User Guide has been updated. You can also find it on the Provider Resources page.
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Effective Monday, July 6, 2015, the Work Conditioning Questionnaire has been replaced by two new versions—one for faxing and one for web-based submissions.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.
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