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Wyoming Medicaid


Our work advances healthcare and improves health for people in Wyoming through our expertise in utilization management review, in partnership with Wyoming Medicaid.

We are staffed by qualified healthcare professionals who provide utilization management tailored to the needs of enrolled Wyoming residents. We are privileged to perform this vital work.


Services We Provide for Wyoming Medicaid

  • Utilization management of durable medical equipment and home health services
    • Prior authorization review
    • Retrospective review


Announcements

Please check this page regularly for updates.

September 1, 2017: Prior Authorization Review for Behavioral Health and Therapy Services Begins November 1
Effective with dates of service November 1, 2017, Qualis Health will perform prior authorization reviews for behavioral health and physical, occupational, and speech therapy services. Please see the Wyoming Medicaid provider bulletin for more about this policy change.

We will be holding webinars to show you how to use the Qualis Health Provider Portal, our online system for submitting review requests. Visit the Provider Education page for webinar dates, times and registration information.

February 24, 2017: Home Health Services Review Begins March 1
Beginning March 1, Qualis Health will begin performing reviews for home health services. All home health services will require prior authorization.


January 20, 2017: DME Prior Authorization Form Now on the Provider Resources Page
You can now download the Wyoming Medicaid DME Medical Supplies & Equipment Prior Authorization Request Form from Qualis Health’s website. Find it on the Provider Resources page in the “Prior Authorization Materials” section.

December 6, 2016: Materials from November Webinar Now Available
Thank you for attending our November 30 webinar! The slides and recording from this session are now available. Links to both files are on the Provider Education page in the “Archives” section.

Correction: Upgrade to 2016 Version of InterQual Criteria Effective December 15
Beginning December 15, 2016, Qualis Health will review DME prior authorization requests using the 2016 version of McKesson’s InterQual Criteria. For items not covered by InterQual Criteria, we will continue to use the Medical Supplies and Equipment Covered Services and Limitations Module. A previous version of this announcement listed the effective date as December 1.

October 3, 2016: Provider Educational Session Materials Now Online
The 2016 Wyoming Medicaid Provider Educational Session webinar recording and presentation slides are now online. You can also find them on the Provider Education page in the “Archives” section.

 

 

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Contact Us

Phone:
(800) 783-8606

Fax:
(877) 810-9265

»Qualis Health Provider Portal

»email Qualis Health Provider Portal Help

Contact Wyoming Medicaid

Amy Buxton
Provider Services Manager
Wyoming Medicaid
Department of Health
Division of Healthcare Financing
Phone: (307) 777-5081
Fax: (307) 777-6964
amy.buxton@wyo.gov

wymedicaid.acs-inc.com


»more contact info