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Indian Health Service (IHS)

IHS

Indian Health Service

Provider Manuals

General Information for Providers 02/2017

Medicaid manual with general information for all provider types.

Indian Health Service/Tribal 638 08/2016

This manual has information specific to your provider type.

Prescription Drug Program, Prior Authorization Chapter 01/2016

Prior authorization requirements and procedures are covered in this chapter.

Passport to Health 11/2015

Everything a provider needs to know to become a successful Passport provider.

Provider Manuals – Replacement Pages

General Information for Providers

02/06/2017 In summary, the Telemedicine Chapter was added as a new chapter.  And the Medically Needy section of the Member Responsibilities Chapter page 6.5 was updated.

08.02.2016

07.12.2016

 

General Information For Providers, July 2016

01.19.2016 General Information for Providers, January 2016: Introduction Regarding HELP Plan Information
01.15.2016 General Information for Providers, January 2016: Introduction Regarding HELP Plan Information
12.31.2015 General Information for Providers, January 2016: HELP Plan-Related Updates and Others
11.17.2015 General Information for Providers, November 2015: Billing Procedures, Revenue Codes 25X and 27X
07.31.2015 General Information for Providers, August 2015: Entire Manual
11.19.2014 General Information for Providers, November 2014: Billing Procedures
10.08.2014 General Information for Providers, September 2014: Billing Procedures
07.22.2014 General Information for Providers, July 2014: Member Eligibility and Responsibilities
06.30.2014 General Information for Providers, May 2014: Entire Manual
If information is found on the website, it has been removed from the manual, and a link to the source is provided.
04.13.2012 General Information for Providers, April 2012: Medicaid Covered Services and Client Eligibility

Indian Health Service/Tribal 638

08.08/2016 Indian Health Service, August 2016:

In Summary, the Cost Share section of the Billing Procedure Chapter was removed and replaced with a referral to the Cost Share section of the General Manual. The Cover Page was changed to reflect the current manual edition date.

 

07.01.2015 Indian Health Service, July 2015: Entire Manual
08.01.2014 Indian Health Service, June 2014: Billing Procedures
04.04.2014 Indian Health Service, February 2014: Multiple Chapters
08.29.2013 Indian Health Service, July 2013: Key Contacts and Billing Procedures
05.15.2013 Indian Health Service, April 2013: Entire Manual
This set of replacement pages includes the entire IHS manual. Content changes are indicated by the addition of a change bar (black line). Text in tables and paragraphs in which text was deleted are not indicated with change bars. For a complete manual without the change bars, see the Provider Manuals section at the top of this page.

Passport to Health

11.09.2015 Passport to Health, November 2015: Passport Referrals

 

   
   
   
   

Medicaid Rules and Regulations

Fee Schedules – IHS

Provider Notices

2017

05/26/2017 Federal Final Rule, "Nondiscrimination in Health Program and Activities” and Implication for Coverage of Services Related to Gender Transition
04/20/2017  Plan First Hysterectomy codes added effective April 1, 2017
04/06/2017 New EPSDT Request Form
02/02/2017 EPSDT ( Children's) Lead Screening Requirements

2016

12/21/2016 Substance Use Disorder Billing
07/28/2016 Montana Plan First Preventive Code Additions
07/25/2016 Admission Date and Statement Covers Period - Revised
07/18/2016 Changes to Member Cost Share Update
07/01/2016 Admission Date and Statement Covers Period
05/19/2016 Changes to Member Cost Share
04/07/2016 Montana Plan First - IUD and Anesthesia Updates
02/01/2016 Basic Medicaid Benefit Increased to Standard Medicaid Benefit
01/15/2016 Standard Medicaid and HELP Plan Claims Processing Rev. 01/19/2016

2015

12/31/2015 Changes to Montana Medicaid
11/03/2015 Services Exempt from Passport to Health Referral
10/01/2015 Changes to the Children's Mental Health Bureau Medicaid Services Provider Manual
09/08/2015 Billing Montana Medicaid for Durable Medical Equipment (DME) Diabetic Supplies
08/28/2015 Substance Use Disorder, Revenue Code 944
08/17/2015 Medicare Crossover Claims With Medicare Non-Covered Charges That Medicaid Allows
08/03/2015 ICD-10 Guidance for Implementing International Classification of Diseases, 10th Edition (ICD-10)
07/31/2015 Adult and Pediatric Specialty Table of Services Available in Montana
07/08/2015 Montana Plan First – Revised List of Plan First Covered Services
02/11/2015 New HCPCS Modifiers – XE, XP, XS, and XU

2014

12/18/2014 Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Changes Final Update
11/25/2014 Telehealth
09/16/2014 Adoption of the New Children's Mental Health Bureau's Medicaid Provider Manual into Administrative Rules of Montana
08/05/2014 Montana Prescription Drug Registry
06/12/2014 ICD-10 Delay
05/13/2014 PERM Provider Educational Webinars
04/22/2014 Modifier Changes for Professional Claim Billers
03/18/2014 Information Regarding CMS-1500
01/29/2014 Centers for Medicare and Medicaid Services (CMS) ICD-10 Provider Readiness Assessment Update
01/09/2014 Using Medicaid Card ID Number When Billing and Checking Eligibility
01/09/2014 Reimbursement Changes for Covered Ancillary Services Provided to Youth in a PRTF and Additional Information Pertaining to PRTF Services

 

IHS/Tribal 638 Training Materials

Tribal and Indian Health Service

Montana Medicaid strives to improve billing capacity within Tribal and Indian Health Service clinics. DPHHS is committed to improving the health of the Indian population in Montana.

For Tribal or Indian Health Service billing questions contact:
Casey Peck, IHS Program Officer, 406.444.4349 or CPeck@.gov
 

Tribal/IHS Meeting Information

06/27/2017 Agenda Agenda June 27, 2017 Handouts/Information 2017 Passport Program
04/25/2017 Agenda
Agenda April 25, 2017   Handouts/Information 2017 HMK Overview
03/28/2017 Agenda Agenda March 28, 2017   Handouts/Information Medicaid Refresher
02/28/2017 Agenda Agenda February 28, 2017   Handouts/Information Telemedicine PowerPoint Slides in PDF and Medicare Savings Plan (MSP) Powerpoint Slides in PDF
11/22/2016 Agenda Agenda November 22, 2016   Handouts/Information Durable Medical Equipment (DME) PowerPoint Slides in PDF
10/25/2016 Agenda Agenda October 25, 2016   Handouts/Information Optometry Presentation PowerPoint Slides in PDF
09/20/2016 Agenda Agenda September 20, 2016 Minutes Minutes/Video of Meeting/Passport Presentation (in mp4) Handouts/Information Passport Presentation PowerPoint Slides in PDF
08/23/2016 Agenda Agenda 08.23.2016 Minutes Minutes/Video of Meeting Handouts/Information Medicaid Transportation Program
06/28/2016 Agenda Agenda 06.28.2016   Handouts/Information HMK Overview
05/24/2016 Agenda Agenda 05.24.2016 Minutes Minutes/Video of MeetingMember Enrollment Tutorial
04/26/2016 Agenda Agenda 04.26.2016   Handouts/Information IHS Provider Enrollment Tutorial

 

Other Resources

EOB R&R Crosswalk PDF and EOB R&R Crosswalk Excel 02/2011
With the implementation of HIPAA, Medicaid discontinued the use of Medicaid EOB codes and began using HIPAA standard reason and remark (R&R) codes. This document crosswalks the HIPAA standard R&R codes to the Medicaid EOB codes. Forms

Prior Authorization Criteria for Specific Services SURS Provider Self-Audit Protocol 10/2015  

To locate older documents, access the Archive Page.