Hospital Contact Forms

To comply with Medicare guidelines, our medical reviews must be completed within tight timeframes. In addition, we often distribute important Medicare-related announcements to, or request Medicare claims-related information from, hospitals.

It is important that our contact database is kept up to date.

Please help Qualis Health maintain accurate records by using our Hospital Roster form to regularly inform us of any changes regarding the personnel designated as your official QIO Contact or Discharge Appeals Contacts.

A separate form should be used to notify us of any changes to your hospital's point-of-contact for quality measure reporting.