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Do you know about our InterQual Connect feature?

Date: 11/01/21

Fort Lauderdale, Florida

Sunshine Health Secure Provider Portal

Sunshine Health values our relationship with our provider partners and believes a key component of meeting provider needs is our Secure Provider Portal. The portal enables providers to conduct business with Sunshine Health from the convenience of their desktops seamlessly and in real time. 

Launched April 1, 2021

Sunshine Health would like to remind you of an exciting tool, InterQual Connect™, which is a feature embedded within our web authorization request process of our Secure Provider Portal. InterQual Connect™ (IQC), is an integrated medical review solution. It enables payers and providers to streamline the medical review process and eliminate redundant reviews. The addition of these features will simplify the provider experience.

InterQual Connect™ is available to Sunshine Health Medicaid, Long Term Care, Serious Mental Illness, Child Welfare, Children’s Medical Services (CMS) Health Plan, Medicare (Allwell) and Marketplace (Ambetter) providers.

The web authorization process and InterQual Connect™ offers several new capabilities:

  • Access integrated InterQual criteria through the provider portal
  • Streamlined web authorization request
  • Access resources that support the InterQual review process
  • View and/or print the review summary
  • Advises users if a service requires/does not require authorization or is not covered
  • Easy access to InterQual Connect™ to complete medical review
    • Completed InterQual medical review will automatically be included with your web authorization submission
    • Possible same day approval based on outcome of a completed InterQual medical necessity review 
  • Identifies non-submitted service lines and provides reason for non-submittal

We believe these updates to our Secure Provider Portal will create a more user-friendly experience and enhance your ease of doing business with Sunshine Health. We hope that you will take a moment to explore these new features.

Please contact Provider Services at 1-844-477-8313 with any questions.