Idaho Medicaid Provider Handbook, Home Health and Hospice Services § 1.4

Telligen, Inc. is Idaho Medicaid’s quality improvement organization (QIO) that reviews Prior

Authorization (PA) requests for durable medical equipment and supplies as listed on the

Numerical Fee Schedule or when a PA would otherwise be indicated. They also conduct

reviews of services.

Telligen, Inc.

670 E Riverpark Ln. Suite 120

Boise, ID 83706

Phone: 1 (866) 538-9510

E-mail: idmedicaidsupport@telligen.com

See the QIO Provider Manual for a listing of diagnoses and procedures that require PA and

details regarding review processes. All PA requests and medical record updates for post

payment medical necessity and DRG validation reviews must use the provider portal.

The status of a PA request submitted to Telligen, Inc. may be checked online via the Telligen

Qualitrac portal or the Gainwell Technologies portal under “Authorization Status”, using your

National Provider Identifier (NPI). If you have questions on a Denial in the Gainwell

Technologies portal, click on the Notes, which will explain the reason for the Denial. See the

General Billing Instructions, Idaho Medicaid Provider Handbook for more information on billing

and requesting prior authorized services.