HCBS Utilization Review/Utilization Management
Purpose Training Memos and Guidance
Purpose of the HCBS UR/UM Program
The Department of Health Care Policy and Financing (HCPF) currently contracts with a vendor, Telligen, to conduct Utilization Review/Utilization Management (UR/UM) reviews. Reviews are conducted to ensure there is no duplication of services and the services requested reflect the identified needs of the waiver participant.
Note: Over Cost Containment (OCC) Reviews no longer apply to PARs effective July 1, 2025.
HCPF requires the HCBS UR/UM review of:
- Children’s Extensive Support (CES) waiver eligibility reviews
- SLS Exception Reviews
Sign up to receive UR/UM and Office of Community Living Communications
Training Materials
Getting Started with Telligen's Qualitrac Review and Provider Portal
- Provider Portal Registration
- Telligen Qualitrac Portal Registration Training - February 2021
- Webinar Recording - February 2021
- Webinar Transcript - February 2021
- Authorized Official Training User Guide - January 2021
- Qualitrac Multi-Factor Authentication Tip Sheet - July 2025
Using Qualitrac
- Using Qualitrac Training Presentation - February 2021
- Webinar Recording - February 2021
- Webinar Transcript - February 2021
- Using Qualitrac Q&A - February 2021
- UR/UM Provider Program Manual - Updated July 2025
- Qualitrac Review Request Entry Guide - Updated March 12, 2021
Nurse Assessor
- Effective August 1, 2025 Health Maintenance Activities (HMA) reviews have been replaced with the Nurse Assessor assessment.
- More information:
Supported Living Services (SLS) Waiver Exception Reviews
- Visit the SLS Waiver Exceptions Review Process webpage to access the SLS Exception Review Request form, training materials, and more
Need Help?
- Telligen Call Center - 833-610-1052
Memos and Guidance