Provider Resources
Provider Resources
Our extensive educational resources greatly support our efforts to improve the utilization of clinical services. We continue to communicate with, educate and bring value to hospitals that provide care for Healthcare and Family Services medical program participants.
CARES and SASS Resources
- CMH Data Entry Guide: CMH Entry Guide for CARES and SASS
- CMH-200 Handbook: Chapter 200 CMH Provider Handbook 2008
- CMH Provider Notices: HFS' CMH Provider Notices
The documents are viewable with Adobe Acrobat ReaderTo print .pdf files, use the Adobe Printer icon on the left side of the .pdf document, do not use the file and print function.You can use the Save icon to save the .pdf file to your computer.
Coding Job Aids
HFS' Codes Subject to Mandatory Admission/Concurrent Review
HFS Attachment List of Codes Subject to Review (includes Attach D, E, F)
IMPORTANT: HFS Attachments A-C are subject to concurrent review. HFS Attachments D and E are subject to retrospective prepayment review ONLY. Attachment F is used for Prior Authorization of elective, inpatient CABG and Back Surgeries.
Please visit our Homepage under the "Quick Resources" section for current lists.
Frequently Asked Questions
To download a pdf file or print the Frequently Asked Questions, click here
eQHealth Educational Presentations
Provider Communications
HFS Provider Notices and Resources
All HFS' Informational Notices are available on their Web site and are archived by year.
eQHealth Provider Communications
eQHealth Provider Updates and Reminder Notices are used to notify providers of any program changes, educational opportunities or to provide other necessary information. Communications are faxed to Hospital-appointed eQHealth Liaisons. The documents are viewable with Adobe Acrobat Reader. To print .pdf files, use the Adobe Printer icon on the left side of the .pdf document, do not use the file and print function. You can use the Save icon to save the .pdf file to your computer.
Provider Training Manual
The Inpatient Provider UR Manual is a comprehensive guide for hospitals. The manual contains updated information regarding policies, procedures and services that eQHealth Solutions offers as Illinois' quality improvement organization.
- Inpatient Provider UR Manual - Short Term Acute Inpatient Care
UR Quick Guide
The UR Quick Guide was developed to aid hospital personnel in submitting clinical information necessary for utilization review.
Hospital Contact Form
Acentra Health keeps the hospital community informed of Healthcare and Family Services (HFS) program changes and sends review notices and updates through communication sent by fax, mail or phone. The following four contacts at your facility play a vital role in receiving and disseminating this information:
eQHealth Liaison
The Liaison is assigned by a member of hospital administration. Their role is to serve as the primary hospital contact regarding utilization program information. It is important to have the appropriate liaison to ensure the information is received by this hospital designee and distributed in a timely manner.
Quality Contact
This contact is identified by hospital administration. Their role is to be the primary quality contact between Acentra and the hospital for all issues relating to quality matters. All quality communication is sent to this contact.
Web Administrator
To access our Web-based review system and provider-specific reports, each hospital must have a Web account and designate a Web administrator for their facility. The Web administrator defines the access rights for all hospital Web users and is responsible for creating login information and maintaining user profiles.
Retro Chart Contact
This hospital-assigned contact will receive an email reminder whenever cases are selected by HFS for retrospective pre- or post-payment medical record review. The email will remind you to have someone logon to eQSuite to get the list of cases and upload medical record sections online.
To add, update or change these contacts, please fill out the Hospital Contact Form and fax it back to us with the updated information.
Would you like to submit a request for reconsideration of a medical necessity denial?
For a copy of the Reconsideration Request form Click here.
- eQSuite PSYCH Web User Guide-Admission Review: A comprehensive user guide for Behavioral Health admission Web reviews
- eQSuite PSYCH Web User Guide-Continued Stay Review: A comprehensive user guide for Behavioral Health continued stay Web reviews
- Frequently Used Provider Reports: A summary of most commonly used Provider Web reports includes an example of each report type.
- eQSuite DRG Web User Guide-Admission Review: A comprehensive user guide for submitting DRG admission reviews (PowerPoint Slides -Revised January 2015)
- eQSuite DRG Web User Guide-Continued Stay Review: A comprehensive user guide for submitting DRG continued stay reviews (PowerPoint Slides -Revised January 2015)
- Quick Guide for 3 Step DRG Discharge: New 3-step process for requesting DRG hospital discharge review through eQSuite (june 2013)
- Web Administrator Guide: Guide for Web Admins to use the User Maintenance tab to add new users and maintain user files for your location
- eQSuite® MENUBAR Guide: A resource guide for the additional features available to eQSuite users.
Additional Provider Resources
Retro Chart
Requests
Reconsideration & Reassessments
