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...

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 implementing a monthly post payment audit process. As a part of the...

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 conditions, or are accessing one of the following services, you may be...

Effective immediately: Prior authorization for the Acute Rehabilitation level of care is no longer required for APR-DRG facilities. As part of this update, prior authorization, concurrent, and continued stay review authorization requirements are no longer required for...

Telligen now has a new automated phone system for checking your review status. Click to read more…