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State of New Mexico - Human Services Department


Provider Resources


Provider Checklists


Coversheet


Admission Criteria


Fax Numbers for Requests for Authorization

Applied Behavior Analysis: (888) 515-2067 toll-free

Waivers:

  • Jackson Class Urgent: (877) 850-7269 toll-free
  • MCO Client Information Update Requests: (888) 562-2755 toll-free
  • Mi Via Participants: (800) 251-9993 toll-free


Urgent Fee for Service Prior Authorizations:
(out-of-state providers & infrequent users—submit less than 12 requests per year)
(888) 562-2755 toll-free


Qualis Health Provider Portal

The Qualis Health Provider Portal is a web-based application for submitting authorization requests.

Go to the Qualis Health Provider Portal

Getting Started: Register

Get started by registering to use the Qualis Health Provider Portal. Complete the appropriate forms in the registration packet and email them to Qualis Health. We will contact you once we receive your registration packet.

Download the Qualis Health Provider Portal registration packet

Qualis Health Provider Portal Resources


Provider Notices


Introduction to Qualis Health's Services

  • Download this flyer for more information about the Level of Care Review services we provide and how to access those services.
  • Download this flyer for more information about the Utilization Management Review for Fee for Service services we provide and how to access those services.

 

 

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