eQHealth Solutions, the QIO-like organization for the Arkansas Department of Human Services (DHS), provides utilization and quality control peer review for Speech Therapy (ST), Occupational Therapy (OT), and Physical Therapy (PT) for Medicaid Beneficiaries Receiving More Than Ninety (90) Minutes per Week services to qualifying Arkansas Medicaid beneficiaries.

Speech Therapy (ST), Occupational Therapy (OT), and Physical Therapy (PT) for Medicaid Beneficiaries Receiving More Than Ninety (90) Minutes per Week will be processed as follows:

 

  1. eQ Health will process all prior authorization requests within seventy-two (72) hours of receipt of complete documentation clearly establishing medical necessity.
  2. All reviews will be conducted by a licensed speech, occupational or physical therapist depending on the type of service under review.
  3. If a PA request does not contain documentation clearly establishing that the requested services are medically necessary, eQ Health will refer the request to a peer reviewer or physician advisor who will determine whether to enter a determination that some or all of the requested care is not medically necessary (adverse decision).

 

Click on the link below regarding Retrospective Reviews - Required Documenation

Required Documentation for PT/OT/ST, EIDT and ADTT (Click Here)