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Provider Services Portal   COVID-19 Provider Information and Notices

Claims Processing Delays

November 9, 2023

The 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, 2023

On 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, 2023

The 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.

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

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.