The Provider Portal, also known as QC Portal, is a comprehensive managed care software that is highly flexible, easy to use and powerful. The software allows PsycHealth providers to verify eligibility, enter referral and authorization requests, submit claims and view the status of all data in real-time from any internet web browser.
QC Portal can show the user up-to-date electronic medical records through the call log system.
Claim History and Submission
QC Portal additionally allows for viewing claim history and submission of manually entered claims and 837 EDI files.
QC Portal uses real-time data to search and preview member eligibility.
QC Portal allows for searching for outpatient mental health service records.
QC Portal also can display authorization history, including inpatient, partial, and intensive outpatient mental health service records.
Claims submissions are reviewed on a bi-weekly basis by the PsycHealth Claims Department. The current status of any claim processed by PsycHealth can be viewed via QC Portal. All claims submissions will be processed in accordance with Illinois law and PsycHealth claim polices and procedures.
If you have any questions about the status displayed by QC Portal, please contact the Claims Department at [email protected].
All in-network contracted Providers with PsycHealth Care Management, LLC. can view and print their Explanation of Benefit reports directly from the secure PsycHealth QC Portal website. PsycHealth will no longer be mailing these EOBs along with the checks.
Once logged into the portal with your ID and Password, select from the Menu – EOB/Payment History. You will be able to select the EOB by Payment Date. Most recent payments are listed first.
If you are an Out of Network Provider, PsycHealth will continue to mail you your EOBs.
The PsycHealth Help Desk for QC Portal related issues can be contacted at: [email protected]. Please be sure to include your name and telephone number when submitting an inquiry to the Help Desk. All requests will be addressed within ten (10) business days.
Please note that Member eligibility information is received on a monthly basis from the medical groups. As such, there may be a lag of up to 30 days between the time the medical group makes a change to the member’s policy and when that change is reflected by QC Portal.
If you have any questions about the eligibility information displayed by QC Portal, please contact the Clinical Care Department at [email protected].
From time to time, PsycHealth will use the System Messages to convey important information to providers. Please review the messages on this screen as they may indicate when QC Portal may be unavailable for use due to system maintenance and/or upgrades.
QC Portal is an internet based application and is subject to occasional outages. If the QC Portal website cannot be reached for any reason please contact us so we may resolve the issue. Please note that most outages are resolved within 24-hours.
Referral and Authorization requests are reviewed on a daily basis by the PsycHealth Clinical Care Department. The current status of any request can be viewed via QC Portal. All referral and authorization requests will be processed in accordance with terms set forth in the PsycHealth Provider Contract.
If you have any questions about the status displayed by QC Portal, please contact the Utilization Management Department at [email protected].