Provider News

Stay on top of the latest provider news from Telligen, including: implementation updates, stakeholder meetings, policy changes and other issues related to services provided to Maryland Medicaid members.

September 8, 2016 - Effective immediately, Telligen has been instructed not to request additional information from providers that are submitting concurrent reviews and for reconsideration of retrospective review denials.  For complete details, please read DHMH transmittal sent September 8, 2016.

August 25, 2016 - The Maryland Department of Health and Mental Hygiene has released information related to changes in preauthorization of certain Durable Medical Equipment requests. Starting September 1, 2016, providers are required to submit these requests electronically through Telligen's web-based portal, Qualitrac.  Please review all three memorandums on this new process explaining applicable codes and process changes. 

July 12, 2016:  New Preauthorization Process for Certain Durable Medical Equipment Requests

August 12, 2016:  Future Submissions of Certain DME Preauthorization Requests

August 12, 2016:  Additional procedure codes to be submitted to Telligen

August 24, 2016 - Please review DHMH concerning lack of information submitted with 3808 retrospective reviews resulting in technical denials. Hospitals submitting 3808 retrospective review request to Telligen need to include the complete medical record of the patient with the request.  Not including the complete medical record is resulting in extended review times and technical denials.  Please read the complete transmittal dated August 24, 2016 for full details.

August 4, 2016 - Telligen is offering Durable Medical Equipment (DME) providers several opportunities for training on their Qualitrac system. Beginning August 22 and continuing through August 31, 2016, Webex trainings will be offered to educate and assist providers with registering, logging into the portal and learning how to submit preauthorization requests.  Please view our Education & Training page for details.

June 20, 2016 - The Department has worked with Telligen and has come up with a solution that will allow the retrospective reviews that had "non-covered" days to be re-reviewed and processed with minimal administrative burden to the hospitals.  Please review the latest DHMH tranmittal for detail.

June 16, 2016 - Please review the most recent DHMH memorandum concerning the Acute Hospital 3808 Correction process.

June 2, 2016 - DHMH has updated the Acute Hospital 3808 Correction Request form to a fillable document for providers.  We are asking all providers to utilize this new form to type in the necessary information.  This will help to ensure accuracy in the corrections process by making the information easier to read and process.  Please continue to fax the completed forms to Telligen at 888-297-4276.

May 25, 2016 - The Qualitrac User Guide has been updated to reflect Acute Care Hospital and Level of Care reviews submission through the Telligen Portal.  The User Guide can be found on the Document Library page.

May 18, 2016 - DHMH issued a message today to inform providers on the process for submitting corrections using the Acute Hospital 3808 Correction Request Form. Please review the memorandum for details.  The Correction Request Form can also be found on the Document Library page of this site.

May 9, 2016 - 3871b reviews will be accepted through the Provider Portal. Any Long Term care facilities that have not filled out their Security Administrator Registration Packet can find it on the website on the Document Library page. Download the Submission of 3871b for Long Term Care Facilities slide deck from the Education and Training page for details.

Telligen Announces Maryland Medicaid Medical Director

March 7, 2016 - Telligen, a leading provider of population health management solutions that improve healthcare quality and lower costs, announces the hiring of Letitia Dzirasa, MD, as Medical Director for the utilization control contract with the Maryland Department of Health and Mental Hygiene.

In her new role, Dr. Dzirasa will provide clinical leadership for physician advisers and nurses performing utilization reviews of selected hospital, nursing facility and community-based services.

Dr. Dzirasa is a board-certified pediatrician and clinical leader with significant experience in the areas of medical management, quality improvement and supporting underserved populations. 

In her previous role as medical director with the Baltimore Medical System, Dr. Dzirasa led the integration of a patient safety program in accordance with The Joint Commission and Patient Centered Medical Home standards. She also leads a pediatrics working group that provides care to underserved patients within Baltimore City Schools and the Baltimore County Health Center. 

Dr. Dzirasa received her medical degree from Meharry Medical College and undergraduate degree from University of Maryland.