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.

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

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Important DME Submission Update

Provider Memo: RE: DME prior authorization requests To expedite the manual pricing process, Idaho Medicaid and the Medical Care Unit are requesting a change in how the DME requests are built and...

All DME Prior Authorization Reviews Now Completed by Telligen

On January 1st, 2022, Telligen began reviewing DME prior authorization requests. All DME prior authorization requests must be submitted to Telligen via the online Qualitrac portal (preferred method)...

Upcoming Post Payment Audit

On July 1, 2021, IDHW moved to the APR-DRG reimbursement model and discontinued the prospective review of certain inpatient stays conducted by UM vendor, Telligen. Due to that change, IDHW will be...

Case Management Self-Referral for Enrollees

Providers: Please take note of this announcement and direct members to it at your discretion. **ATTENTION MEDICAID MEMBERS** If you or Medicaid members in your family have one of the following...