1. Idaho Medicaid: Telligen Provider Portal
October 27, 2016 and
November 3, 2016

2. Provider Portal Training

3. Key points for Review Submission
Prior Authorization Review – to be submitted in advance of the admission to receive medical necessity approval for the admission when required by the Idaho Medicaid program
Concurrent (Continued Stay) Review – submitted when:
A hospital stay exceeds prior authorization approval,
Any hospital admission exceeds three days, or
A cesarean section stay exceeds four days
Retrospective Review – submitted for retroactive eligibility and service has been provided
Telligen utilizes Milliman Care Guidelines for all reviews.

4. Telligen Portal – Concurrent Review Submission Update
Telligen has added additional questions around concurrent review submission to confirm that authorization numbers are maintained from prior authorization to concurrent and across concurrent reviews submitted for the same stay.
Log in to the Telligen Provider Portal at idmedicaid.telligen.com
Use the Sign In link on the top right corner of the page.

5. Select the Request Type
Select one of the options from the drop down box:
Inpatient Psychiatric
Inpatient Medical/Surgical
Inpatient Rehabilitation Services
Outpatient Medical/Surgical
Choose the review type that you are requesting a review for.

6. Select the appropriate review timing
When you select "Concurrent" the page will update and display another question.
If this review is related to a previously submitted case, select Yes. The system will then ask you to enter the authorization number for the previously submitted review(s). Submit the Authorization number from the previous reviews(s) and select next to continue the submission.
If this is the initial review for a stay, and no previous reviews related to this stay have been submitted, select No. Then select next to continue the submission.

7. Provider Portal: Retrospective Review Submission
Retrospective reviews need to have the actual admission date and discharge date entered for the review.
If you are submitting a Retrospective Review to Telligen and the dates of service are prior to February 1, 2016, please fax your review to Telligen.
Reviews can be faxed to Telligen using: (866)

8. Telligen Provider Portal: Landing Page
Use buttons to filter the cases in your queue.
Use column headings to reorder the data.
Use search boxes to find specific information.
Click on Case ID to get more details.
Use to navigate through the pages
Use this button to begin entering a new case.

9. Patient Portal: Case ID
After a case has been submitted, Users can look up the case and perform additional actions or view details.
A User can search for a case using the search fields or by navigating through the pages.
Once the case has been located, click on the Case ID field to select it.

10. Patient Portal: Case Details
Clicking on the Case ID opens the Case Details page.
Click the Reference ID to see a summary page and view correspondence
Use the “Attach Documentation” button to add additional information to the case
Click the Request Reconsideration button to request a reconsideration.

11. Patient Portal: Summary Page and Correspondence
When the User clicks on the Reference ID, a summary page opens where the case information, supporting documentation, and status can be reviewed.
This page contains any correspondence attached to the case.
Clicking on the link(s) contained in the Letters section will open the correspondence for review.

12. Important Numbers Website: IDMedicaid.Telligen.com
Call Center: (866)
Help Desk address:
Phone number of Boise office: (866)
Utilization Review Fax number: (866)
Case Management Fax Number: (888)

13. Implementation Information
Questions