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July 24, 2017

Surgery and Procedures

To determine whether or not a surgery or procedure requires a Prior Authorization, please see the current Medicaid Fee Schedule

Please see Codes Requiring Telligen Review to determine if a prior authorization is required by Telligen.

To apply for access to the Telligen Portal please fill out the registration packet located in the document library on the Telligen site. Once approved, providers can submit a request to either Telligen or Medicaid’s Medical Care Unit, but not both.   

Those requiring a prior authorization, and are not reviewed by Telligen, are reviewed by the Medical Care Unit as established in the list of surgeries requiring prior authorization from Medicaid's Medical Care Unit.

The Medical Care Unit also reviews a select number of inpatient hospital procedure codes.

 

Medical Care Unit Authorizations

Prior authorizations that are not reviewed by Telligen should be faxed to the Medical Care Unit at 1 (877) 314-8779 on the Surgery and Procedure Prior Authorization Form. Please, include proof of medical necessity with your request. Requests are only accepted by fax.

The status of a prior authorization request may be checked online at the Molina Health PAS portal under “Authorization Status”, using your NPI, or by contacting Molina at 1 (866) 686-4272.

For other questions or general information, contact 1 (866) 205-7403.

Telligen, Inc. Authorizations

Prior authorization requests through Telligen, Inc. may be submitted:

Online: Telligen provider portal.
Fax: 1 (800) 826-3836
Mail: Telligen
670 East Riverpark Lane, Suite 170
Boise, ID 83706

The status of a prior authorization request may be checked online at the provider portal, or by contacting Telligen, Inc. at 1 (866) 538-9510.

Please, contact Telligen, Inc. at 1 (866) 538-9510 if you require additional information or assistance.

Contact

Medical Care Unit 

Phone: 1 (866) 205-7403
Fax: 1 (877) 314-8779

Telligen, Inc.

ATTN: Prior Authorizations
 670 East Riverpark Lane, Suite 170 
Boise, Idaho 83706

 Phone: 1 (866) 538-9510
Fax: 1 (866) 539-0365