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 3 business days 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 3 business days after receipt and review of all documentation. |
.
FSP Reconsideration Request Form Fax to (800) 418-4039