REQUESTING REVIEW FOR RESIDENTIAL SERVICES

eQHealth Solutions’ utilization review enables the Department to determine if residential treatment services are medically necessary, reasonable and appropriate for the FSP youth based on their clinical needs. This requires a prior authorization request/approval, and if necessary a request for continued stay by the residential facility for this level of care.

SASS/FSP Coordinator - Prior Authorization
If the care plan determines that residential treatment is an appropriate option, the FSP Coordinator will submit a request for prior authorization to eQHealth. You must first receive an approval letter from eQHealth to submit along with your RAP to a Residential Treatment Facility. Please fax the following four, required documents to eQHealth at (800) 418-4039, using Subj: FSP RTF Prior Auth:

1. Completed eQHealths Prior Authorization Form (click here)

2.  C
opy of Psychiatric Evaluation
      • Dated within the last 90 days

3.    Copy of Psychological Evaluation

      • Dated within last 18 months
      • Must include IQ testing

4.    Copy of the current IATP (includes MHA and ITP);  OR the IM+CANS


Residential Treatment Facility - Continued Stay Request
Submit your request to eQHealth a maximum of 10 business day prior or a minimum of 3 full business days prior to the last approved day. Please fax the following three required documents to eQHealth at (800) 418-4039, Subj: FSP RTF Continued Stay

1. Completed eQHealth’s Continued Stay Form (click here)   

2.  Copy of the current IATP (includes MHA and ITP);  OR the IM+CANS

3.  Copy of the Family Success Plan/Discharge Plan