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   

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  

If you are a YES Class member and would like the opportunity to file a complaint anonymously with the YES program team, click here.

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...

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)...