Medicaid Utilization Control Agent Transition and Medical Eligibility Reviews

The Department is pleased to announce that Telligen was competitively selected to become Medicaid’s utilization control agent. Please see the memos and transmittals below for all communication sent to providers. Additionally, all updated and fillable forms are available on this site for download.
 
Please visit Telligen's website for more information.
  
Nursing Facility Level of Care Related Forms
 
H​ospital Related Forms

 

Memoranda and Transmittals

 

 UCA_Communications

 
  
  
April 13, 2016 - Hospital Administrators April Trainings.pdf
  
April 14, 2016 - LOC Submissions via Qualitrac - announcement.pdf
  
April 29, 2016 - Hospital Administrators Memo Submitting_3808s_using_MA_numbers.pdf
  
April 29, 2016 - Hospital Administrators Memo_Submitting_preauths_and_concurrent_reviews.pdf
  
August 12, 2016 - DME SGD codes.pdf
  
August 12, 2016 - DME Transmittal PT 4-17 Future Submissions of Certain DME Preauthorization Requests.pdf
  
August 24, 2016 - Hospital Administrators Lack of additional info results in technical denials.pdf
  
February 1, 2016 - Model Waiver on Interim process.pdf
  
February 1, 2016 - Nursing Facilities Additional Instructions for Interim Reviews.pdf
  
February 3, 2016 - Eligibility Memo on Utilization Control Agent.pdf
  
January 12, 2016 - Hospital Administrators Transmittal PT 34-16 New Utilization Control Agent.pdf
  
January 12, 2016 - Transmittal PT 33-16 New Utilization Control Agent as of February 1, 2016.pdf
  
January 15, 2016 - Hospital Administrators Transmittal PT 35-16 New Utilization Control Agent.pdf
  
January 21, 2016 - Hospital Administrators regarding Medical Eligibility Review Submission.pdf
  
January 21, 2016 - Nursing Facilities regarding Medical Eligibility Review Submission.pdf
  
January 22, 2016 - Brain Injury on Interim process.pdf
  
January 22, 2016 - Medical Day Care Memo on interim process.pdf
  
January 28, 2016 - Hospital Administrators Transmittal PT 36-16.pdf
  
July 1, 2016 - Prior Authoriation and Concurrent Process 070116.pdf
  
July 21, 2016 - DME Introduction of New UCA - Telligen - and New Preauth Process for DME Providers.pdf
  
June 15, 2016 Hospital Administrators Updated 3808 Correction Process.pdf
  
June 16, 2016 - Hospital Administrators Reviews of 3808s with non-covered days.pdf
  
June 22, 2016 - Hospital Administrators MHA Follow up.pdf
  
March 10, 2016 - Hospital Administrators Transmittal Future submissions of 3808s to Telligen.pdf
  
March 14, 2016 - Hospital Administrators Management of 3808 backlog.pdf
  
March 2, 2016 - Hospital Administrators - Trainings.pdf
  
March 22, 2016 - Update on Processing X02s and DHMH 4245.pdf
  
March 3, 2016 - Changes to Interim process for NF and Hospitals.pdf
  
May 11, 2016 - Transfer of X02s to DHMH.pdf
  
May 18, 2016 - Hospital Administrators 3808 Correction Process.pdf
  
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