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Case Management for Pregnant & Postpartum Women with Substance Use

New Service Alert: We now offer specialized case management for pregnant and postpartum women with substance use disorder (SUD). This service joins our comprehensive suite of case management programs, all provided at no cost to Idaho Medicaid members.   Key...

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 click on the orange “Submit Request” button  

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Changes to Prior Auth and Medical Record Submission

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...

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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 approved. Effective Immediately: All manually priced miscellaneous (MISC)...

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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) or via secure fax to (866) 539-0365. Portal access is easy and...

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