Telligen Medicaid Services for the State of Idaho

Welcome to the Telligen website supporting Utilization Management for the State of Idaho. This site is built to provide easy access to the Qualitrac provider portal for submitting clinical cases, as well as current news and resources that pertain to the Telligen contract with the state. Please use the Contact page if you have any questions or encounter issues with the website.

Idaho Medicaid Provider Annual Survey: click here

 

Referrals Made Easy: Case Management Assistance

To request assistance from a Telligen Nurse Case Manager, click here.

Qualitrac Login

Web application used by healthcare providers to submit clinical care requests for review

Provider Portal Registration

New users need to register to gain access to Qualitrac. The provider's portion of the registration takes less than 10 mins. 

REGISTER
FREQUENT QUESTIONS
CHECK REVIEW STATUS

OPPORTUNITY FOR REVERSAL OF CLAIM RECOUPMENT

Retrospective post payment Medical Necessity and DRG validation cases previously technically denied for not submitting medical records are now eligible to be reopened for review.   Reopening...
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APR DRG Updates: Effective 10/1/2024

Acute Care Hospitals will be subject to updates to the 3MTM All Patient Refined DRG (3M APR DRG) Software reimbursement methodology effective October 1, 2024.  This update will result in changes to...
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New Idaho Behavioral Health Plan launching July 1st, 2024.

New Idaho Behavioral Health Plan launching July 1st, 2024.  Telligen will no longer do reviews for inpatient psychiatric hospital stays or pediatric residential treatment facilities. Launch Plan ...
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Attention Idaho Medicaid CHIS Providers

Provider Memo: Attention Idaho Medicaid CHIS Providers: You will no longer be prompted to enter MCG Guideline Documentation when submitting requests. You will now see this and all you need to do is...
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