• Behavior Analysis: Effective immediately, the GT modifier is no longer needed on the authorization request for services.
  • Attention Behavior Analysis Service Providers: In accordance with the Florida Medicaid Authorization Requirements Policy, eQHealth Solutions may request additional information as necessary to determine medical necessity. When inadequate information is received that does not support the medical necessity of services, eQHealth notifies providers by requesting additional clinical information via eQSuites. Providers have (2) two business days to respond to the information request. If the information is not received within (2) two business days, the review will be denied for insufficient information. If you submitted a request for prior authorization of behavior analysis services in the months of May or June and received a request from eQHealth for additional information and have not responded, please respond by July 20, 2018 with the requested information. If you do not respond by that date, eQHealth will begin to process denials for insufficient information. Moving forward, requests for additional information that are not responded to by the provider within two business days, will be denied.
  • Behavior Analysis: Beginning June 27, 2018, all BA services delivered under Florida Medicaid must have received prior authorization from eQHealth. Prior authorizations issued by Beacon will not be valid for BA services delivered after June 26th.