Qualis Health provides case management and utilization management services to the Idaho Department of Health and Welfare, Division of Medicaid. We are staffed by qualified healthcare professionals who provide services tailored to the needs of enrolled Idaho residents.
The Idaho Medicaid program provides healthcare for eligible elderly and disabled individuals and eligible low-income pregnant women, children and parents. In support of the Medicaid program, we currently serve more than 240,000 Medicaid clients in Idaho. We are privileged to be instrumental in this vital work.
Get Ready for ICD-10 with New Select Diagnoses/Procedures Review Guidelines
We have posted new Select Diagnoses/Procedures Review Guidelines that include CPT and ICD-10. Use these guidelines for dates of service beginning October 1, 2015. Do not use this list for dates of service before October 1.
For dates of service through September 30, 2015, continue using the current Select Diagnoses/Procedures Review Guidelines that include CPT and ICD-9 (also known as Provider Manual Appendix A).
You can find both of these documents on the Provider Resources page.
Revised Provider Manual Available
The Idaho Medicaid Provider Manual has been revised and is effective August 1, 2015. It includes updated Select Diagnoses/Procedures Review Guidelines. You can also find these documents on the Provider Resources page.
Qualis Health Provider Portal Transition Completed
In November we transitioned from iEXCHANGE to the Qualis Health Provider Portal.
As of November 1, 2014:
You'll find more information, including how-to videos and the Qualis Health Provider Portal User Guide, on the Provider Resources page.
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