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.
Transition to Online Review Requests Coming Soon
October 26, 2016: Beginning January 1, 2017, providers located in Washington state must use the Qualis Health Provider Portal to submit requests for imaging, spinal injections and therapy services (PT, OT, WC).
In order to submit requests via the Qualis Health Provider Portal, your organization must be registered with both OneHealthPort and the Qualis Health Provider Portal.
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