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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


Please check this page regularly for updates.

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

DME Prior Authorization Form Now on the Provider Resources Page
January 20, 2017: 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.

Materials from November Webinar Now Available
December 6, 2016: 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.

Provider Educational Session Materials Now Online
October 3, 2016: 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.

Guide for Qualis Health Provider Portal Administrators Available
September 15, 2016: We have created a special guide just for Qualis Health Provider Portal Administrators. It describes your responsibilities and gives instructions for carrying out those tasks. Find it on the Provider Resources page under the heading "Qualis Health Provider Portal Resources."



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

(800) 783-8606

(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


»more contact info