eQHealth Solutions’ utilization review enables the Department to determine if residential treatment services are medically necessary, reasonable and appropriate for the FSP youth based on their clinical needs. This requires a prior authorization request/approval, and if necessary a request for continued stay by the residential facility for this level of care.

SASS/FSP Coordinator - Prior Authorization
If the care plan determines that residential treatment is an appropriate option, the FSP Coordinator will submit a request for prior authorization to eQHealth. You must first receive an approval letter from eQHealth to submit along with your RAP to a Residential Treatment Facility. Please fax the following four, required documents to eQHealth at (800) 418-4039, using Subj: FSP RTF Prior Auth or by secure email at 

1. Completed eQHealths Prior Authorization Form - PDF    Prior Auth Form - Word

2.  C
opy of Psychiatric Evaluation
      • Dated within the last 90 days

3.    Copy of Psychological Evaluation

      • Dated within last 18 months
      • Must include IQ testing

4.    Copy of the current IATP (includes MHA and ITP);  OR the IM+CANS

Residential Treatment Facility - Continued Stay Request
Submit your request to eQHealth a maximum of 10 business day prior or a minimum of 3 full business days prior to the last approved day. Please fax the following three required documents to eQHealth at (800) 418-4039, Subj: FSP RTF Continued Stay or by secure email at  

1. Completed eQHealth’s Continued Stay Form (click here)   

2.  Copy of the current IATP (includes MHA and ITP);  OR the IM+CANS

3.  Copy of the Family Success Plan/Discharge Plan