Effective August 1, 2023, all Idaho Medicaid Providers must use the Qualitrac Portal to submit prior authorization requests and to upload medical records for post payment medical necessity and DRG validation reviews.
Starting August 1, 2023, all providers are required to submit prior authorization requests to Telligen via the online Qualitrac Portal. Faxed, mailed, or called in requests will no longer be accepted.
Starting August 1, 2023, all providers are required to upload requested medical records for post payment Medical Necessity reviews and DRG validation reviews via the online Qualitrac Portal. Faxed, mailed, or medical records submitted to other portals (CIOX, MRO, Share Care, etc.). will no longer be accepted.
Mark Your Calendar for important upcoming provider training sessions hosted on Zoom and following the links to join a meeting.
- June 29th: 10:30 AM to 12:00 Mountain Time: https://telligen.zoom.us/j/86275350548
- July 19th: 2:30 PM to 4:00 PM Mountain Time: https://telligen.zoom.us/j/88028974534
The first one hour will be for provider portal registration and access, and instruction on submitting prior authorization requests. The last 30 minutes will be instructions on how to upload records for post payment DRG validation and medical necessity reviews. To request the zoom link via email. Please contact Miranda Wilkinson at firstname.lastname@example.org
It is recommended to attend one session of each of the provider training. If you are unable to do so, you may follow this process to register for the Qualitrac portal:
- If you do not currently have access to the provider portal through Telligen, please visit http://idmedicaid.telligen.com and select the “Sign Up!” button under “First Time Portal Registration.” If you have any questions or need help signing up, you may contact Telligen at email@example.com.
- Starting August 1, 2023, please submit all prior authorization and medical record requests to Telligen via their online provider portal by selecting “Qualitrac Login” at http://idmedicaid.telligen.com or by going directly to the provider login at http://myqualitrac.com/.
- For questions regarding how to submit a review through Telligen using the Qualitrac Provider Portal or any other Telligen related questions, please contact Telligen via email at IDMedicaidSupport@telligen.com or by phone at 866-538-9510.
- If you are not sure whether or not a code requires prior authorization or who reviews the code, please view the most updated Idaho Medicaid Numerical Fee Schedule found on the “For Providers” website.
- While we strongly recommend all providers to create an account in the portal, if for some reason you are unable to access the portal, you may appeal directly to Idaho Medicaid to continue to alternative avenues for submitted prior authorization requests and submitted medical record requests. Please email any appeal request to MedicaidQIO@dhw.idaho.gov. IDHW will notify Telligen of all providers that are an exception to this process.