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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.

February 25, 2019: Skilled Nursing Services Review Begins April 1. Join Us for Training in March.
On April 1, 2019, Qualis Health will begin performing prior authorization review of skilled nursing services for Wyoming Medicaid waiver participants. We process reviews through our secure online system, the Qualis Health Provider Portal. We invite skilled nursing providers to learn how to use the QHPP at our March training sessions. Visit the Provider Education page for complete details.

January 28, 2019: Revised DME Provider Manual Now Available
The Medical Supplies and Equipment Covered Services and Limitations Module has been updated. You can also find a link to this document on the Provider Resources page under “Provider Manual.”

December 28, 2018: Prior Authorization Code List Updated
We have updated the Codes Requiring Prior Authorization document, effective January 1, 2019. You can also find a link to this file on the Provider Resources page under the heading “Prior Authorization Materials.”

August 28, 2018: DME Prior Authorization Code List Updated
We have updated the DME Prior Authorization List in the Codes Requiring Prior Authorization document. You can also find a link to this file on the Provider Resources page under the heading “Prior Authorization Materials.”

July 31, 2018: Behavioral Health Review Guidelines Webinar Recordings & Slides Online
We recently held training sessions on the new Wyoming Medicaid behavioral health review guidelines. If you weren’t able to attend, you can watch the webinar recordings or download the slides on our Provider Education page.

July 13, 2018: Register for Behavioral Health Review Guidelines Training
As of July 1, 2018, Qualis Health is following new guidelines for Wyoming Medicaid behavioral health reviews. Join us at one of three online sessions to get in-depth training on these new guidelines. Webinars are on July 23, July 26, and July 27. Registration is required—sign up today!

June 26, 2018: Just Released—Guidelines for Outpatient Behavioral Health Reviews
A new document is now available that covers the guidelines for behavioral health reviews performed by Qualis Health. Download it now.

June 25, 2018: Revised Maintenance Therapy Guidelines Available
The Maintenance Therapy (PT, OT, ST) Review Guidelines have been updated. You can also find this document on the Provider Resources page under the header “Prior Authorization Materials.”

June 4, 2018: Prior Authorization Code List Updated
We have updated the Codes Requiring Prior Authorization document. You can also find a link to this file on the Provider Resources page under the heading “Prior Authorization Materials.”

 

 

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Contact Us

Phone:
(800) 783-8606

Fax:
(877) 810-9265

»Qualis Health Provider Portal

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.portal.conduent.com


»more contact info