Nebraska Department of Health and Human Services, Division of Medicaid and Long Term Care
Provider Resources
Provider Manuals
- Utilization Review Home Health Care & Private Duty Nursing
- Hospital Inpatient/Outpatient Services
- Inpatient/Outpatient Services Provided at a Critical Access Hospital
- Acute Inpatient Rehabilitation Hospital Services
- Ambulatory Surgical Center
Forms
- Home Health Nursing Services Questionnaire
- Home Health Extended Nursing Services Questionnaire
- Home Health/Private Duty Nursing Request for Correction/Change for Existing Authorization
- Home Health Care Facility Fax Cover Sheet
- Private Duty Nursing Fax Cover Sheet
- Bariatric Surgery Checklist
Memos
- Qualis Health Provider Memo 12-06
- Qualis Health Provider Memo 10-06
- Qualis Health Provider Memo 07-23
- Qualis Health ASC Med Record Memo
Provider Bulletins
Resource Materials
- Home Health & Private Duty Nursing Frequently Asked Questions
- Claims Denial Process Narrative
- Claims Denial Process Flowchart
- Contact and Resource Information
Adobe Acrobat® PDF files can be opened using Adobe Acrobat Reader. If you do not have Reader, you can get it FREE from the Adobe website.
Contact Us
Initiate a Review
Phone:
(877) 560-2618
Fax:
(877) 560-2619
Home Health Fax:
(877) 850-7269
Contact Nebraska Medicaid
Home Health Services
Gaylene Jeffries
Program Specialist
(402) 471-9415
Hospital Services
Margaret Booth, RN, MSN
Hospital Program Manager
(402) 471-9380
»visit the Nebraska Medicaid website
Connect with Qualis Health 
