Enhancements to the Telligen Provider Portal
June, 2014
Telligen is pleased to announce that the Provider Portal has undergone site enhancements to better serve our customers. Users accessing the portal will find the following enhancements supporting providers submitting Prior Authorization requests,and Providers with RetrospectiveCases sampled by the Nebraska Medicaid Department of Health and Human Services:
- Users may now view results of previously submitted reviews utilizing filter options available at the top of the “Medical Authorization” screen. The “Medical Authorization” screen defaults to viewing all cases, but users may select to only view approved, denied, or under review cases, etc.
- Providers who have cases selected for retrospective review by Nebraska DHHS will have the ability to see the cases selected on the Provider Portal (once registered and after secure login) and upload the medical record through the Provider Portal. Providers who have access to the portal will also be able to review the status of the retrospective sampled cases and upload additional information when required.
- Updates to the “Add Authorization” – When users submit new authorization requests, the provider search has been updated to display the Provider Name, NPI and Zip code, when available. Users may search by the provider’s name, and select from the results listed based on the provider name, NPI and Zip code (when available).
- Requested Services – When submitting a request for authorization, after the CPT has been entered and the “Service Information” page has been completed, if the CPT code entered does not require prior authorization, or is not a covered service by Nebraska Medicaid, users will immediately receive a notification that the service requested is not eligible for review. This prevents users from entering unnecessary authorizations or requesting authorizations for non-covered services. If you receive the message “No Review Required: The service you have requested is not covered or does not require Prior Authorization. Please check your Nebraska Medicaid Manual.”, and believe you have entered a valid service request, please use the browser back feature and check the CPT code and modifier you entered as well as the authorization type selected. The code entered must be valid (including modifier, if appropriate/required), for the type of authorization you are requesting.
- Example - If you select the authorization type of “Private Duty” and enter the CPT code G0154 with a “TD” modifier, you will receive the message noted above. The CPT Code is valid for Home Health Services, but not approvable under Private Duty Nursing. To correct this, simply update the authorization category (Skilled Nursing Visit), and submit the request.
If you have any questions regarding any of the enhancements, or experience any issues, please contact Telligen at 1-855-638-7949or email at: .