Service Specific Record Review (SSRR) Checklists – These checklists provide an easy guide for gathering the information needed to help you prepare for your Qlarant review.
Operational Policies & Procedures – A comprehensive manual describing Qlarant’s policies and Discovery Review procedures. It provides clear guidance to help you understand what to expect from a Qlarant review from start to finish.
Scoring Methodologies (NEW) – These informational tools outline how scores are calculated for each type of Provider Discovery Review (PDR). Select the appropriate PDR type below to review the scoring methodology.
Revisions to the Qlarant Operational Policies and Procedures Manual has been posted.
Updates made:
Applicable language related to the APD iConnect grace period has been incorporated in response to APD Advisory #2026‑016 (see page 20);
Provider Discovery Review (PDR) section has been expanded to address the three review types conducted by Qlarant: PDR, PDR Qualified Organizations (QO) and PDR Consumer Directed Care (CDC) Representatives;
Provider Discovery Review process timeframe details have been updated;
Overall reorganization to increase clarity and remove outdated content;
General formatting edits.
Qlarant’s Customer Service Representative is available to assist if you have any questions at FSQAPcustomerservice@qlarant.com or 1-866-254-2075.
If you disagree with the findings related to noted billing discrepancies in your Provider Discovery Review (PDR) report, you may request a Reconsideration Review. The Reconsideration Request must be made in writing(using the Reconsideration Request form located below) and received within 30 days of the annual PDR report mailing date.
