Document Library

Security Admin Registration Form - The Telligen Qualitrac Provider Portal is a web application which allows healthcare providers to request and view the status of medical reviews. Each provider organization will delegate administrative rights to one or more individuals within their organization to serve as Security Administrator. The Security Administrator will be the point of contact for the organization and have the ability to add, remove or edit Provider Users accounts. Each Security Administrator must complete the Provider Portal - Security Admin Registration Form.


    C-Section Concurrent Review Fax
    Concurrent Review Fax
    Inpatient Psych Concurrent Fax
    Inpatient Psych (Over 21) Prior Authorization Fax
    Inpatient Psych (Under 21) Prior Authorization Fax
    Prior Authorization Fax
    Rehabilitation Prior Authorization Fax

Idaho Plan Benefits

    Medicaid Basic Benefit Plan
    Medicaid Enhanced Benefit Plan

Manuals and User Guides  

    Auto Authorization FAQs
    Idaho Physician Fee Schedule (under Current Fee Schedules)
    Idaho Prior Authorization Codes
    New Concurrent Review Submission Process
    Provider Manual
    Qualitrac User Guide

Qualitrac 3.0

Provider Communication

Provider Resources

Provider Education