January 10, 2020
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.
About Mountain-Pacific Quality Health — Mountain-Pacific is a 501(c)(3) nonprofit corporation and holds federal and state
contracts that allow them to oversee the quality of care for Medicare and Medicaid members. Mountain-Pacific works within
Montana, Wyoming, Alaska, Hawaii and the U.S. Pacific Territories of Guam and American Samoa and the Commonwealth
of the Northern Mariana Islands to help improve the delivery of health care and the systems that provide it. MountainPacific’s goal is to increase access to high-quality health care that is affordable, safe and of value to the patients they serve.
Learn more at www.mpqhf.org.
About Telligen — For more than 45 years, Telligen has been transforming lives and economies by improving health. Telligen
serves commercial clients and government programs at the federal, state and local level, improving health outcomes for
millions of people nationwide. Telligen is a 100 percent employee-owned ESOP company. For more information, visit www.telligen.com