The Montana Department of Health and Human Services (DPHHS) awarded Mountain-Pacific Quality Health a contract to help efficiently and cost-effectively improve health outcomes for Montanans enrolled in Medicaid.
Medicaid provides free or low-cost health insurance coverage to more than a quarter of a million Montanans who need financial help to receive medical and behavioral health services across the state or, when necessary, outside the state. Through a review process, Mountain-Pacific helps Medicaid members get the medical services, equipment and supplies that are most appropriate to their health and health care needs.
Under this new contract, Mountain-Pacific is subcontracting some of the work to Telligen, an organization headquartered in West Des Moines, Iowa, with national Medicaid and quality improvement experience. While Mountain-Pacific will still provide most of the Medicaid medical review services, Telligen will be responsible for behavioral health reviews and other evaluations.
“Montana’s health care needs are always changing, and we knew we needed to come up with innovative solutions to adapt to those changes,” said Sara Medley, Mountain-Pacific’s chief executive officer. “Our staff has extensive clinical experience, and by partnering with Telligen and adding their expertise to the mix, we will offer even higher quality services and technology to the State, to health care providers and, most importantly, to Montana’s Medicaid members.”
Telligen also offers Montana Medicaid their industry leading technology platform, called Qualitrac. As part of this platform, Mountain-Pacific and Telligen have introduced an online portal, where Montana providers can submit review requests while keeping Medicaid members’ private medical records secure.
“We have received very positive feedback from our provider partners about the new portal,” Medley said. “We all share the same goal, which is to advocate for patients and patient safety while making sure Medicaid benefits are being properly used. This portal is part of how we make sure our Medicaid support is as effective, efficient and least burdensome as it possibly can be.”
Mountain-Pacific has held Montana Medicaid contracts since 1974. The new, two-year contract started on October 1 and will extend to October 2021 with an option for five, one-year extensions.