Document Library
Provider Portal Registration Form
Qualitrac, the Mountain-Pacific Quality Health Medicaid provider portal, is a web-based application that allows health care providers to submit requests for reviews. This document provides information about how to become a registered user and complete the necessary forms. Access provider portal registration and form.
Provider User Guide for Montana Medicaid Services Processed through Qualitrac
This user guide demonstrates the fields providers will encounter in the Qualitrac portal and provides a quick reference to important information about each level of care and the associated timelines for each. Access the provider user guide.
Behavioral Health Provider User Guide for Montana Medicaid Behavioral Health Services Transitioning to Qualitrac
This user guide demonstrates the fields providers will encounter in the Qualitrac portal and provides a quick reference to important information about each level of care and the associated timelines for each. Access behavioral health provider user guide.
Behavioral Health Forms
- Youth Certificate of Need Psychiatric Residential Treatment Facility (PRTF) – Access PRTF youth certificate of need form
- Youth Continued Stay Request Authorization Form – Psychiatric Residential Treatment Facility (PRTF) – Access PRTF youth continued stay request form
- Youth Discharge from Services Notification Form – Access youth discharge notification form
- Youth Prior Authorization Request Form – Psychiatric Residential Treatment Facility (PRTF) – Access PRTF youth prior authorization form
- Provider forms for Children’s Mental Health services – Located on the Montana Department of Public Health and Human Services (DPHHS) website
- Provider forms for Addictive and Mental Disorders Division services – Located on the Montana Department of Public Health and Human Services (DPHHS) website
- Mountain-Pacific Quality Health forms crosswalk – Mountain-Pacific has developed a crosswalk for all these forms, which provides the names of the forms, the services for which the forms are used, their current online locations and how the forms should be submitted.