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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.

Medicaid Claims Payment Delayed

September 8, 2023

A problem was identified with the weekly payment cycle impacting approximately 74,000 claims. Impacted claim payments that would normally be issued on Monday, September 11, 2023 will be rescheduled with the following weekly cycle. The delayed payments will be issued on Monday, September 18, 2023. The issue is being closely monitored and steps are being taken to ensure impacted claims will process correctly within the next cycle.

We sincerely apologize for any inconvenience. Please contact Provider Relations if there are questions or concerns at (800) 624-3958 or (406) 442-1837, or email MTPRHelpdesk@conduent.com.

EVV Survey for Personal Care and Home Health Services

June 2, 2023

Montana Department of Public Health and Human Services (DPHHS) is implementing the Netsmart Electronic Visit Verification (EVV) system to electronically verify the delivery of services for Medicaid members receiving personal care or home health care services to comply with the 21st Century Cures Act.

Netsmart, the vendor that the Department selected to provide an EVV solution to Montana Medicaid providers and to collect EVV data from third party EVV vendors serving Montana Medicaid providers, is conducting a survey on behalf of the Department to collect information from Montana Medicaid providers who provide personal care and home health care services that are subject to visit verification requirements. The information provided will assist the Department to properly plan communication, rollout, and training activities for the provider community.

Applicable providers are encouraged to complete the Montana Provider EVV Survey by June 30.
  • If you are a Self-Direct Employer, you do not need to complete the survey.
  • If you use Acumen as your Fiscal Intermediary, Acumen will complete the survey.
  • If you are a Self-Direct Agency with Choice, the provider agency you work with will complete the survey.
If you have questions, please email EVVQuestions@mt.gov.

Provider Revalidation for Providers Who Utilized Expedited Enrollment During the PHE

May 22, 2023

On April 17, 2023, Montana Healthcare Programs began sending revalidation notices to providers who utilized the expedited enrollment process following the CMS 1135 waiver policy during the Public Health Emergency. These providers must submit a revalidation by July 10, 2023. Failure to complete the revalidation by this date can lead to disenrollment from participation in Montana Healthcare Programs.

Providers who received the revalidation letter will need to: (1) Log into the MPATH Provider Services Portal to complete the revalidation process and upload supporting documentation. (2) Select the radio button on the workbench next to the current enrollment. (3) Select the Revalidation button from the left-hand menu to begin the process.

Complete the provider revalidation by July 10, 2023.

Please contact Provider Relations via email at MTPRhelpdesk@conduent.com or call Provider Relations at (800) 624-3958 if you have questions or concerns.


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:


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

The Nuts and Bolts of the Surveillance Utilization Review Section (SURS) Training
Jennifer Tucker, SURS Supervisor, October 19, 2023 at 2pm Mountain Time (1 Hour)

Billing 101

Jennifer Stirling, Provider Enrollment Supervisor, Conduent, November 16, 2023 at 2pm Mountain Time (2 Hours)

Provider Enrollment

Jennifer Stirling, Provider Enrollment Supervisor, Conduent, December 21, 2023 at 2pm Mountain Time (2 Hours)

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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