eQHealth Reconsideration Requests

Upon completion of clinical review, if an eQHealth Physician Reviewer renders a denial outcome, the Provider may request a reconsideration of that denial for the following review types
  • FSP Continued Enrollment/Renewal Application -  SASS FSP Coordinator
  • Prior Authorization of Residential Services  - SASS FSP Coordinator
  • Continued Stay of Residential Services  - Residential Treatment Facility

The reconsideration request form must be completed and faxed to eQHealth within the required timeframes, depending on the review type

Reconsideration
Review Type
               


Requestor/Timeline
  
 
eQHealth Determination Timeline
Continued FSP Enrollment SASS FSP Coordinator may request within 5 calendar days from the date of the eQHealth denial notice    
Final eQHealth determination made within 3 business days after receipt and review of all documentation

Prior Auth of Residential Services SASS FSP Coordinator may request within 10 calendar days from the date of the eQHealth denial notice
Final eQHealth determination made within 1 business day after receipt and review of all documentation

Continued Stay of Residential Services RTF may request within 3 calendar days from the date of eQHealth denial notice      Final eQHealth determination made within 1 business day after receipt and review of all documentation.
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                     FSP Reconsideration Request Form                  Fax to (800) 418-4039