Welcome to the Montana Healthcare Programs
Provider Information Website.
2024 W-9 Form Required
October 15, 2024 Department of Administration is no longer accepting prior versions of the W-9 forms. All W-9 forms must have 2024 on the top, left-hand corner. All enrollments and updates that are not approved as of 10/15/2024 that required a W-9 form will need a revised W-9 if the version is not 2024. The current W-9 form is on the Forms page of this website in the Forms P-Z tab.
Revalidation Requirements Deadline
October 11, 2024The Department of Public Health and Human Services (DPHHS) has resumed Provider Revalidation post the COVID 19 Public Health Emergency. Provider Revalidation is a federally required compliance measure for providers to verify and update their enrollment information every five years to remain eligible for participation with Montana Healthcare Programs. Currently there are many providers that have not completed their revalidations. Failure to complete overdue revalidations by December 31, 2024, will result in suspended payments. Failure to complete overdue revalidations by December 31, 2024, will result in suspended payments.
Providers should review the current Provider Revalidation List on the Provider Information website to check their revalidation status. Providers may also review their Correspondence History on the MPATH Provider Services Portal. Montana Healthcare Programs sent notification letters beginning August 2023 to the address on file 90 days before the revalidation due date.
Free Virtual Provider Training Opportunity for Members with Intellectual and Developmental Disabilities
October 4, 2024In partnership with the Montana Developmental Disabilities Program (DDP), the Montana Department of Public Health and Human Services (DPHHS) is making a free training opportunity available for Medicaid providers interested in better understanding the special healthcare needs of members with intellectual and developmental disabilities (IDD).
Participants may earn Continuing Medical Education (CME) or Continuing Education Unit (CEU) credits through the self-paced, virtual training. For details on the training course, refer to the IDD Healthcare eLearn Course Information Flyer.
Registration is open to physicians, nurse practitioners, nurses and physician assistants. Providers may register through Montana Curriculum in IDD Healthcare eLearn Course Registration on the IntellectAbility website.
The training is available for up to 500 attendees on a first-come first-serve basis. Seats are also being held for students in the health and human services and/or medical fields.
Attention: Providers Partnered with Change Healthcare Can Resume Electronic Claims Submission to Montana Healthcare Programs
May 9, 2024Change Healthcare has re-established their connection with Montana Healthcare Programs. Providers can resume sending claims via their standard practice prior to the Change Healthcare cyberattack. If you are submitting claims and continue to experience issues, please reach out through your biller to connect with the Change Healthcare resources. For more information, please see reference to Montana Medicaid at https://www.unitedhealthgroup.com/changehealthcarecyberresponse#latestupdates.
Claims Processing Delays
November 9, 2023The Department is working with Conduent to address claims processing delays due to staffing shortages. Department staff are actively evaluating common edits that cause claims to suspend and making procedural and system changes to streamline claims processing. Changes to the 40-year-old claims system are challenging; however, as opportunities for automation are identified, they are prioritized for development and implementation. Additionally, Conduent has added numerous staff resources to expedite claims processing. Finally, the State Medicaid Director, Mike Randol, meets with Conduent executive leadership weekly to ensure continued progress toward resolving the claims processing delays.
Claims Payment Discrepancy Update
September 15, 2023On September 13, 2023, the Department of Public Health and Human Services (DPHHS) identified a claims payment issue with the September 11, 2023, payment cycle. The cause of this issue was that the payment file for August 14, 2023, was re-run and providers received their August 14, 2023 payments again in error instead of the payments they should have received on September 11, 2023.
To correct this issue, this weekend, the Department, will reverse the EFT payments or cancel the warrants that providers received in error, and process the proper payments due to providers for September 11, 2023.
The remittance advices providers received on September 11, 2023, will match the corrected payments providers will receive on or before Tuesday September 19, 2023. Providers should use the remittance advices received on September 11, 2023, for reconciliation purposes. The only item that will not match is the warrant number for the corrected payment.
Providers will receive their payments as usual for September 18, 2023.
Impacted providers will also receive a notification to their email on file. The Department sincerely apologizes for this issue and has taken immediate steps to prevent this issue from re-occurring in the future.
Claims Payment Discrepancy Identified
September 13, 2023The Department of Public Health and Human Services (DPHHS) has identified a claims payment issue with the September 11, 2023 payment cycle. The issue has caused under payments or overpayments to some providers. Impacted providers will note that their deposit information does not match their 835s or Statement of Remittance (SOR). We are diligently working to identify impacted payments and are taking steps to reconcile and resolve the issue. Updates will be provided as soon as information becomes available.
For claims questions or additional information, contact Montana Provider Relations at (800) 624-3958 or (406) 442-1837 or email Montana Provider Relations Helpdesk.
Visit the Montana Healthcare Programs Provider Information website to access your provider type page. Choose Resources by Provider Type in the left-hand menu.
Information Reminder
Providers are able to access information 24/7 by calling Provider Relations at (800) 624-3958.
When the system answers, Providers choose Option 7. Option 1 is for pharmacies requesting unlock and Option 5 is for members.
On the next menu, select one of the following options:
OPTION 1: Last 5 PAYMENTS
OPTION 2: CLAIMS STATUS
OPTION 3: MEMBER ELIGIBILITY
OPTION 4: PROVIDER ENROLLMENT SUPPORT
OPTION 5: VALIDATE PROVIDER NUMBER
OPTION 6: GET EDI HELP
OPTION 7: WEB PORTAL PASSWORD RESET
We appreciate the work you do at all hours of the day and night to serve Montana Healthcare Program members. The IVR is there to help you get the information you need when you need it.
Online Training Available
Monthly Provider Enrollment
Amanda Boyd, Enrollment Supervisor, Conduent, Second Wednesday of every month at 10am Mountain Time (1 Hour)
• These trainings will be on the second Wednesday of every month at 10am. Providers must register for each occurrence they wish to attend.
• This is a general enrollment training not a series of trainings.
Documentation from a Review Perspective
Jennifer Tucker, SURS Supervisor, DPHHS, November 21, 2024 at 2pm Mountain Time (1 Hour)
Diabetes Prevention Program
Melissa House, Diabetes Program Manager, DPHHS, December 19, 2024 at 2pm Mountain Time (1 Hour)
To register for upcoming Online Training and access to previous Training PowerPoints, please visit the Training page at https://medicaidprovider.mt.gov/training.
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