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.
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