State of Alaska, Department of Health and Social Services, Division of Health Care Services

From our Anchorage office, we collaborate with Alaska's Medicaid - Health Care Services. Our staff is composed of Alaskans who serve their fellow community members with services specifically tailored to the needs of Alaska residents. We are privileged to continue providing this vital work.

Services We Provide for Alaska Medicaid - Health Care Services

• Case management
• Assessment (quality of care) review
• Utilization management activities
  • Pre-admission review
  • Concurrent review
  • Retrospective review
• Expedited and standard appeals
• TEFRA new application and renewal review (for Medicaid-eligible children who meet requirements for institutionalization but receive care at home)
• Educational seminars on care management
• Special case review

Announcements

• The Spring Provider Educational Session will be held on May 30. Visit the Provider Education page for more information.
• April 2013: The Alaska Medicaid Department of Health and Social Services Provider Manual has been updated. Download it here or find it on the Provider Resources page.
• Effective April 15, 2013, providers will no longer submit outpatient imaging authorization requests to Xerox. Instead, requests will be processed by Qualis Health. Providers will be required to submit all outpatient imaging authorization requests to Qualis Health via the web-based review system, iEXCHANGE®. You can download the Provider Bulletin and Outpatient Imaging Pre-certification List here, or from the Provider Resources page.

• Current as of January 2013:
  • Select Diagnoses/Procedures Pre-certification List
• Current as of January 2012:
  • Concurrent Review Request Form
  • Provider Bulletin (February 2011)
• Presentation: 2011 Provider Education Conference - Care Management Overview
• New utilization management phone number as of March 8, 2011: (888) 240-0437
• Effective April 1, 2011, providers will be required to submit all utilization management reviews via the Qualis Health web-based review system, iEXCHANGE®. Read the February 2011 Provider Bulletin or get iEXCHANGE training.
• Provider Bulletin, July 2010

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