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Medicaid
- Acute Care Hospital Review
- Acute Care Hospital Review Forms
- Chronic Disease Hospital Review
- Chronic Disease Hospital Review Forms
Acute Care Hospital Review
Certified to conduct utilization review in Connecticut and Rhode Island, Qualidigm reviews requests for acute care hospital services. Our staff nurses look at the type of care and services that hospitals or their physicians request and the appropriateness of the setting for needed care. These utilization review services also include requests for out-of-state inpatient hospitalizations or services, inpatient rehabilitation and transplant services.
Tools & Resources
CONNCUR Provider Portal is live!
Starting April 1, 2010 Connecticut acute care hospitals are using a web-based portal to submit requests for Connecticut Medicaid authorizations to Qualidigm.
Please check with your CONNCUR Provider Portal Contact for more information.
News: May 10, 2010
Qualidigm and ZeOmega Launch Jiva Provider Portal
30 Connecticut Acute Care Hospitals Serving Medicaid Members to Increase Customer Satisfaction
Acute Care Service Review Forms
Acute Care Hospital Review | Chronic Disease Hospital Review
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Chronic Disease Hospital Review
Qualidigm is responsible for reviewing Medicaid clients in Connecticut and border state chronic disease hospitals (CDHs). This process is in accordance with section 17b-262-787 of the Regulations of Connecticut State Agencies as implemented by the Department of Social Services (DSS). The initial phase of this review involves patients admitted to CDHs beginning December 1, 2009.
A separate process will be used to review the continued stay for eligible clients who were admitted prior to December 1, 2009. A third process will be used to review clients who were not eligible at the time of admission, but who are granted eligibility during their stay or after discharge. The implementation date and description of those processes will be communicated by DSS and Qualidigm at a later date.
- Chronic Disease Hospitals CONNCUR Authorization Review Process
Chronic Disease Hospitals CONNCUR Review Requirements
Chronic Disease Hospital Review Forms
Acute Care Hospital Review | Chronic Disease Hospital Review
