{"id":7057,"date":"2019-03-04T09:58:07","date_gmt":"2019-03-04T16:58:07","guid":{"rendered":"https:\/\/93fd47b736.nxcli.net\/corporate\/?page_id=7057"},"modified":"2024-10-09T11:14:36","modified_gmt":"2024-10-09T17:14:36","slug":"medicaid-portal-document-library","status":"publish","type":"page","link":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/","title":{"rendered":"Medicaid Portal &#8211; Document Library"},"content":{"rendered":"<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner.png\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-15169 alignleft\" src=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-300x44.png\" alt=\"\" width=\"750\" height=\"110\" srcset=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-300x44.png 300w, https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-1024x151.png 1024w, https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-768x113.png 768w, https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-1536x226.png 1536w, https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-2048x302.png 2048w\" sizes=\"(max-width: 750px) 100vw, 750px\" \/><\/a><\/p>\n<div id=\"header_right\">\n<div id=\"portal_sign_in_button\"><a href=\"https:\/\/myqualitrac.com\" class=\"su-button su-button-style-flat\" style=\"color:#FFFFFF;background-color:#f16649;border-color:#c1523b;border-radius:0px\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"color:#FFFFFF;padding:0px 38px;font-size:27px;line-height:54px;border-color:#f69480;border-radius:0px;text-shadow:none\"> Portal Sign In<\/span><\/a><\/div>\n<div id=\"portal_sign_registration\"><a style=\"font-size: small; margin-left: 75px;\" href=\"https:\/\/powerforms.docusign.net\/04dd8d07-86c3-408e-aeef-50a61354f2c1?env=na3&amp;acct=4957888b-75e8-44d9-849a-ce8f4db18623\" target=\"blank\" rel=\"noopener\"><strong>Portal Registration<\/strong><\/a><\/div>\n<div id=\"prior_auth\"><\/div>\n<\/div>\n<div class=\"clearcontent\">\n<p><a href=\"\/corporate\/medicaid-portal-home\/\"><img loading=\"lazy\" decoding=\"async\" class=\"boxathree card-1\" src=\"\/corporate\/wp-content\/uploads\/2019\/03\/Home-icon.png\" alt=\"image\" width=\"150\" height=\"175\" \/><\/a><a href=\"\/corporate\/medicaid-portal-home\/medicaid-portal-document-library\/\"><img loading=\"lazy\" decoding=\"async\" class=\"boxazero card-1 currentbox\" src=\"\/corporate\/wp-content\/uploads\/2019\/03\/Document-Library-icon.png\" alt=\"image\" width=\"150\" height=\"175\" \/><\/a><\/p>\n<p><a href=\"\/corporate\/medicaid-portal-home\/medicaid-portal-education-training\/\"><img loading=\"lazy\" decoding=\"async\" class=\"boxafour card-1\" src=\"\/corporate\/wp-content\/uploads\/2019\/03\/Education-icon.png\" alt=\"image\" width=\"150\" height=\"175\" \/><\/a><\/p>\n<p><a href=\"\/corporate\/medicaid-portal-home\/medicaid-portal-faqs\/\"><img loading=\"lazy\" decoding=\"async\" class=\"boxaone card-1\" src=\"\/corporate\/wp-content\/uploads\/2020\/03\/FAQsQuicknote-icon.png\" alt=\"image\" width=\"150\" height=\"175\" \/><\/a><\/p>\n<p><a href=\"\/corporate\/medicaid-portal-home\/medicaid-portal-provider-news\/\"><img loading=\"lazy\" decoding=\"async\" class=\"boxatwo card-1\" src=\"\/corporate\/wp-content\/uploads\/2019\/03\/Providers-icon-1.png\" alt=\"image\" width=\"150\" height=\"175\" \/><\/a><\/p>\n<p><a href=\"\/corporate\/medicaid-portal-home\/medicaid-portal-contact-us\/\"><img loading=\"lazy\" decoding=\"async\" class=\"boxafive card-1\" src=\"\/corporate\/wp-content\/uploads\/2019\/03\/Contact-Us-icon.png\" alt=\"image\" width=\"150\" height=\"175\" \/><\/a><\/p>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"clearcontent\">\n<h1><\/h1>\n<h1><strong>Document Library<\/strong><\/h1>\n<p><strong>Provider Portal Registration Form<\/strong><br \/>\nQualitrac, the Mountain Pacific 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. <a href=\"https:\/\/powerforms.docusign.net\/04dd8d07-86c3-408e-aeef-50a61354f2c1?env=na3&amp;acct=4957888b-75e8-44d9-849a-ce8f4db18623\" target=\"_blank\" rel=\"noopener\">Access provider portal registration and form<\/a>.<\/p>\n<p><strong>Provider User Guide for Montana Medicaid Services Processed through Qualitrac<br \/>\n<\/strong>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. <a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Qualitrac-Provider-User-Guide_12.15.23-508Compliant.pdf\" target=\"_blank\" rel=\"noopener\">Access the provider user guide<\/a>.<\/p>\n<p><strong>Behavioral Health Provider User Guide for Montana Medicaid Behavioral Health Services Transitioning to Qualitrac<\/strong><br \/>\nThis 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. <a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/08\/Qualitrac-BH-Provider-User-Guide_revised-08.13.24-508.pdf\" target=\"_blank\" rel=\"noopener\">Access behavioral health provider user guide<\/a>.<\/p>\n<p><strong>Behavioral Health Forms<\/strong><\/p>\n<ul>\n<li>Youth Certificate of Need Psychiatric Residential Treatment Facility (PRTF) &#8211; <a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/CMHB_prtf_certificate_of_need_508-Branded_07.2024-Revised.pdf\" target=\"_blank\" rel=\"noopener\">Access PRTF youth certificate of need form<\/a><\/li>\n<li>Youth Continued Stay Request Authorization Form &#8211; Psychiatric Residential Treatment Facility (PRTF) &#8211; <a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2019\/12\/CMHB_prtf_continued_stay_request_authorization_form-508_Branded.pdf\" target=\"_blank\" rel=\"noopener\">Access PRTF youth continued stay request form<\/a><\/li>\n<li>Youth Discharge from Services Notification Form &#8211; <a href=\"\/corporate\/wp-content\/uploads\/2019\/12\/CMHB_discharge_notifications_form_508-Branded.pdf\" target=\"_blank\" rel=\"noopener\">Access youth discharge notification form<\/a><\/li>\n<li>Youth Prior Authorization Request Form &#8211; Psychiatric Residential Treatment Facility (PRTF) &#8211; <a href=\"\/corporate\/wp-content\/uploads\/2019\/12\/CMHB_prtf_prior_authorization_form-508-Branded.pdf\" target=\"_blank\" rel=\"noopener\">Access PRTF youth prior authorization form<\/a><\/li>\n<li>Provider forms for Children&#8217;s Mental Health services &#8211;\u00a0<a href=\"https:\/\/dphhs.mt.gov\/dsd\/cmb\/ChildrensMentalHealthProviderForms\" target=\"_blank\" rel=\"noopener\">Located on the Montana Department of Public Health and Human Services (DPHHS) website<\/a><\/li>\n<li>Provider forms for Addictive and Mental Disorders Division services &#8211; <a href=\"https:\/\/dphhs.mt.gov\/amdd\/FormsApplications\" target=\"_blank\" rel=\"noopener\">Located on the Montana Department of Public Health and Human Services (DPHHS) website<\/a><\/li>\n<li>Mountain Pacific forms crosswalk &#8211; Mountain Pacific has developed <a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/03\/MT-UM-Forms-Crosswalk_20220331.pdf\" target=\"_blank\" rel=\"noopener\">a crosswalk for all these forms<\/a>, 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.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<div class=\"clearcontent\">\n<hr \/>\n<\/div>\n<h6><em>This project is funded in whole or in part under a Contract with the Montana Department of Public Health and Human Services. The statements herein do not necessarily reflect the opinion of the Department.<\/em><\/h6>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner.png\"><\/a><\/p>\n<p><a href=\"https:\/\/myqualitrac.com\" class=\"su-button su-button-style-flat\" style=\"color:#FFFFFF;background-color:#f16649;border-color:#c1523b;border-radius:0px\" target=\"_blank\" rel=\"noopener noreferrer\"> Portal Sign In<\/a><br \/>\n<a style=\"font-size: small; margin-left: 75px;\" href=\"https:\/\/powerforms.docusign.net\/04dd8d07-86c3-408e-aeef-50a61354f2c1?env=na3&amp;acct=4957888b-75e8-44d9-849a-ce8f4db18623\" target=\"blank\" rel=\"noopener\">Portal Registration<\/a><\/p>\n<p><a href=\"\/corporate\/medicaid-portal-home\/\"><\/a><a href=\"\/corporate\/medicaid-portal-home\/medicaid-portal-document-library\/\"><\/a><br \/>\n<a href=\"\/corporate\/medicaid-portal-home\/medicaid-portal-education-training\/\"><\/a><br \/>\n<a href=\"\/corporate\/medicaid-portal-home\/medicaid-portal-faqs\/\"><\/a><br \/>\n<a href=\"\/corporate\/medicaid-portal-home\/medicaid-portal-provider-news\/\"><\/a><br \/>\n<a href=\"\/corporate\/medicaid-portal-home\/medicaid-portal-contact-us\/\"><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>Document Library<br \/>\nProvider Portal Registration Form<br \/>\nQualitrac, the Mountain Pacific 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. <a href=\"https:\/\/powerforms.docusign.net\/04dd8d07-86c3-408e-aeef-50a61354f2c1?env=na3&amp;acct=4957888b-75e8-44d9-849a-ce8f4db18623\" target=\"_blank\" rel=\"noopener\">Access provider portal registration and form<\/a>.<br \/>\nProvider User Guide for Montana Medicaid Services Processed through Qualitrac<br \/>\nThis 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. <a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Qualitrac-Provider-User-Guide_12.15.23-508Compliant.pdf\" target=\"_blank\" rel=\"noopener\">Access the provider user guide<\/a>.<br \/>\nBehavioral Health Provider User Guide for Montana Medicaid Behavioral Health Services Transitioning to Qualitrac<br \/>\nThis 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. <a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/08\/Qualitrac-BH-Provider-User-Guide_revised-08.13.24-508.pdf\" target=\"_blank\" rel=\"noopener\">Access behavioral health provider user guide<\/a>.<br \/>\nBehavioral Health Forms<\/p>\n<p>Youth Certificate of Need Psychiatric Residential Treatment Facility (PRTF) &#8211; <a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/CMHB_prtf_certificate_of_need_508-Branded_07.2024-Revised.pdf\" target=\"_blank\" rel=\"noopener\">Access PRTF youth certificate of need form<\/a><br \/>\nYouth Continued Stay Request Authorization Form &#8211; Psychiatric Residential Treatment Facility (PRTF) &#8211; <a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2019\/12\/CMHB_prtf_continued_stay_request_authorization_form-508_Branded.pdf\" target=\"_blank\" rel=\"noopener\">Access PRTF youth continued stay request form<\/a><br \/>\nYouth Discharge from Services Notification Form &#8211; <a href=\"\/corporate\/wp-content\/uploads\/2019\/12\/CMHB_discharge_notifications_form_508-Branded.pdf\" target=\"_blank\" rel=\"noopener\">Access youth discharge notification form<\/a><br \/>\nYouth Prior Authorization Request Form &#8211; Psychiatric Residential Treatment Facility (PRTF) &#8211; <a href=\"\/corporate\/wp-content\/uploads\/2019\/12\/CMHB_prtf_prior_authorization_form-508-Branded.pdf\" target=\"_blank\" rel=\"noopener\">Access PRTF youth prior authorization form<\/a><br \/>\nProvider forms for Children&#8217;s Mental Health services &#8211;\u00a0<a href=\"https:\/\/dphhs.mt.gov\/dsd\/cmb\/ChildrensMentalHealthProviderForms\" target=\"_blank\" rel=\"noopener\">Located on the Montana Department of Public Health and Human Services (DPHHS) website<\/a><br \/>\nProvider forms for Addictive and Mental Disorders Division services &#8211; <a href=\"https:\/\/dphhs.mt.gov\/amdd\/FormsApplications\" target=\"_blank\" rel=\"noopener\">Located on the Montana Department of Public Health and Human Services (DPHHS) website<\/a><br \/>\nMountain Pacific forms crosswalk &#8211; Mountain Pacific has developed <a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/03\/MT-UM-Forms-Crosswalk_20220331.pdf\" target=\"_blank\" rel=\"noopener\">a crosswalk for all these forms<\/a>, 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.<\/p>\n<p>&nbsp;<\/p>\n<p>This project is funded in whole or in part under a Contract with the Montana Department of Public Health and Human Services. The statements herein do not necessarily reflect the opinion of the Department.<\/p>\n","protected":false},"author":16,"featured_media":0,"parent":7056,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"class_list":{"0":"post-7057","1":"page","2":"type-page","3":"status-publish","5":"entry"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Medicaid Portal - Document Library - Mountain Pacific<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Medicaid Portal - Document Library - Mountain Pacific\" \/>\n<meta property=\"og:description\" content=\"Portal Sign In Portal Registration     &nbsp;  Document Library Provider Portal Registration Form Qualitrac, the Mountain Pacific 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) &#8211; Access PRTF youth certificate of need form Youth Continued Stay Request Authorization Form &#8211; Psychiatric Residential Treatment Facility (PRTF) &#8211; Access PRTF youth continued stay request form Youth Discharge from Services Notification Form &#8211; Access youth discharge notification form Youth Prior Authorization Request Form &#8211; Psychiatric Residential Treatment Facility (PRTF) &#8211; Access PRTF youth prior authorization form Provider forms for Children&#8217;s Mental Health services &#8211;\u00a0Located on the Montana Department of Public Health and Human Services (DPHHS) website Provider forms for Addictive and Mental Disorders Division services &#8211; Located on the Montana Department of Public Health and Human Services (DPHHS) website Mountain Pacific forms crosswalk &#8211; 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. &nbsp;  This project is funded in whole or in part under a Contract with the Montana Department of Public Health and Human Services. The statements herein do not necessarily reflect the opinion of the Department.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/\" \/>\n<meta property=\"og:site_name\" content=\"Mountain Pacific\" \/>\n<meta property=\"article:modified_time\" content=\"2024-10-09T17:14:36+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-300x44.png\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/\",\"url\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/\",\"name\":\"Medicaid Portal - Document Library - Mountain Pacific\",\"isPartOf\":{\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-300x44.png\",\"datePublished\":\"2019-03-04T16:58:07+00:00\",\"dateModified\":\"2024-10-09T17:14:36+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/#primaryimage\",\"url\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner.png\",\"contentUrl\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner.png\",\"width\":2456,\"height\":362},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Medicaid Portal &#8211; Home\",\"item\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Medicaid Portal &#8211; Document Library\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/#website\",\"url\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/\",\"name\":\"Mountain Pacific\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Medicaid Portal - Document Library - Mountain Pacific","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/","og_locale":"en_US","og_type":"article","og_title":"Medicaid Portal - Document Library - Mountain Pacific","og_description":"Portal Sign In Portal Registration     &nbsp;  Document Library Provider Portal Registration Form Qualitrac, the Mountain Pacific 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) &#8211; Access PRTF youth certificate of need form Youth Continued Stay Request Authorization Form &#8211; Psychiatric Residential Treatment Facility (PRTF) &#8211; Access PRTF youth continued stay request form Youth Discharge from Services Notification Form &#8211; Access youth discharge notification form Youth Prior Authorization Request Form &#8211; Psychiatric Residential Treatment Facility (PRTF) &#8211; Access PRTF youth prior authorization form Provider forms for Children&#8217;s Mental Health services &#8211;\u00a0Located on the Montana Department of Public Health and Human Services (DPHHS) website Provider forms for Addictive and Mental Disorders Division services &#8211; Located on the Montana Department of Public Health and Human Services (DPHHS) website Mountain Pacific forms crosswalk &#8211; 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. &nbsp;  This project is funded in whole or in part under a Contract with the Montana Department of Public Health and Human Services. The statements herein do not necessarily reflect the opinion of the Department.","og_url":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/","og_site_name":"Mountain Pacific","article_modified_time":"2024-10-09T17:14:36+00:00","og_image":[{"url":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-300x44.png"}],"twitter_misc":{"Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/","url":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/","name":"Medicaid Portal - Document Library - Mountain Pacific","isPartOf":{"@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/#website"},"primaryImageOfPage":{"@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/#primaryimage"},"image":{"@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/#primaryimage"},"thumbnailUrl":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-300x44.png","datePublished":"2019-03-04T16:58:07+00:00","dateModified":"2024-10-09T17:14:36+00:00","breadcrumb":{"@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/#primaryimage","url":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner.png","contentUrl":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner.png","width":2456,"height":362},{"@type":"BreadcrumbList","@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-document-library\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/"},{"@type":"ListItem","position":2,"name":"Medicaid Portal &#8211; Home","item":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/"},{"@type":"ListItem","position":3,"name":"Medicaid Portal &#8211; Document Library"}]},{"@type":"WebSite","@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/#website","url":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/","name":"Mountain Pacific","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/pages\/7057"}],"collection":[{"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/comments?post=7057"}],"version-history":[{"count":0,"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/pages\/7057\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/pages\/7056"}],"wp:attachment":[{"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/media?parent=7057"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}