Welcome to the Montana Healthcare Programs
Provider Information Website.

Provider Services Portal

 

 

New Provider Services Portal for Enrollment, Maintenance and Claims Entry available 12/13/2021.

November 30, 2021

Important:
There will be a temporary freeze on new provider enrollments beginning 12/4/2021 through 12/13/2021. Additionally, emailed provider file update requests will no longer be accepted as of 12/10/2021, however, faxed provider file updates will continue to be processed with the focus on moving all updates to the new provider services module in 2022.

Montana Healthcare Programs is excited to introduce a new Provider Services Module. Beginning December 13, 2021, you will notice a change to the online enrollment links. All providers seeking to enroll with Montana Healthcare Programs will be directed to the new MPATH online application offering a more efficient way to enroll, update information and easily submit claims!

Provider Enrollment Portal - The enrollment portal is a self-service online system that will allow providers to enroll as a Montana Healthcare Programs provider.
The portal enables secure and efficient processing of the enrollment application. Significant improvements include:

  • Ability to upload supporting documents - No need to fax or email any portion of the application or supporting documentation.
  • Faster application processing - The application process is consolidated to one online submission. The portal will guide applicants through the requirements by section. Application forms have required fields with help information icons on every page.
  • Online user guide support - Detailed user guide is available to support all features of the provider service module.

Provider Maintenance Features - Once a provider is active with the portal, the process of updating information is very efficient. Updating the license, address and other relevant information can be done online without the need to fax or email information. Key features:

  • Upload support for multiple document types - including .doc, .pdf, jpg and more.
  • All updates can be submitted and managed online via the secure portal - Simply utilize the update option in the portal.

MPATH Claims Entry Solution - The claims entry solution is an online tool allowing providers to manually enter claims. Available options include:

  • Claim form templates - The system allows users to create and save templates for common claim submissions. No need to start from scratch every time.
  • Diagnosis and Procedure code look up - The system has code look up features to assist with entering correct information.
  • Ability to submit multiple claim types - including Professional, Facility and Dental claims.
  • Great alternative to WinASAP5010 - The claims entry solution is a free, simple to use and providers can enter claims without converting and uploading files.
  • Electronic Claim Adjustments - Paper adjustment forms are no longer required. The provider service module allows for online claim adjustments.

The new provider services module will be an improvement to the enrollment and maintenance experience which may include time and cost savings.

For further questions, please contact Provider Relations via email: MTEnrollment@conduent.com. Additional information will be posted once it becomes available.

Provider Service Module training dates are now available, please see the training page https://medicaidprovider.mt.gov/Training for details.

 

American Rescue Plan Act of 2021

Revised November 4, 2021
This announcement was originally posted August 20, 2021.

Montana Home and Community Services Spending Narrative and Plan Submitted September 28, 2021.

The American Rescue Plan Act of 2021 (ARPA) provides a unique opportunity to improve home and community-based service (HCBS) provision for Montanan’s enrolled in the Montana Medicaid program.

Section 9817 of the ARPA provides states with a one year 10-percentage point increase to the federal medical assistance percentage (FMAP) for certain Medicaid expenditures that meet the ARPA definition of HCBS.

States are then able to invest the saved state funding in eligible activities that enhance, expand, or strengthen HCBS under the Medicaid program. The investment of saved state dollars can further be matched with federal Medicaid funds dramatically increasing the impact for HCBS recipients and providers.

For more information regarding the American Rescue Plan Act of 2021 and the CMS response to the original submission, please refer to:

MT Conditional Approval 9817 ARP
ARPA Home and Community Services Spending Plan and Narrative

Supplemental Payments are a component of the Home and Community Services Spending Plan. Additional Information on Supplemental Payments

 

Applied Behavior Analysis (ABA) Services State Plan Amendment

July 29, 2021

The Applied Behavior Analysis Services State Plan Amendment, which includes Autism services, will be submitted to CMS for review by September 30, 2021. While the State Plan Amendment is under review, Montana Medicaid will not process claims for the proposed expanded CPT codes and services. Public notice detailing the proposed changes to the Preventive Services Autism Treatment Services State Plan.

Approved CPT service codes will be billable retroactive to August 1, 2021. Claims can be billed for up to 365 days after the service is provided. If you have questions regarding this change, please contact Barbara Doggett at Barbara.Doggett@mt.gov or by telephone at (406) 444-3878.

This announcement will be sent to the Board Certified Behavior Analysis (BCBA) interested parties lists from the Developmental Disabilities Program. Updates to this announcement will be made as information becomes available.

 

Montana Uninsured COVID-19 Testing and Treatment Program Expiration

On June 30, 2021, Governor Gianforte issued Executive Order Number 10-2021. This Executive Order rescinds Executive Order Number 2-2021 and lifts the Montana state of emergency.

Effective July 1, 2021, this declaration ends the Montana Uninsured COVID-19 Testing and Treatment Program. While the program has ended, claims with a date of service on or before June 30, 2021, may continue to be submitted for reimbursement.

Providers are encouraged to utilize the Health Resources and Services Administration Uninsured COVID-19 Testing, Treatment, and Vaccine Administration Program.

For additional provider information, please see the provider notice "Adoption Of Temporary Emergency Rule To Allow for COVID-19-Related Regulatory Discretion Beyond The Expiration Of The Governor-Declared State Of Emergency"

 

Additional Fax Number for Provider Relations Now Available

Provider Relations has added a second fax number, 888-772-2341. If the primary number is busy, please use the new fax number. Both lines can be used for faxed requests for Provider Relations.(Posted 03/12/2020).

 

Elimination of Copayments

Effective January 1, 2020, all claims paid will no longer post a copayment amount. For specifics, please refer to the Elimination of Copayment Provider Notice and the Copayment Elimination FAQs.

 

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. (posted 08/16/2019)

Online Training Available

New Provider Services Module
Deb Braga, Provider Relations Field Representative, Conduent, January 20, 2022 at 1:30pm Mountain Time (2.5 hours)
Outpatient Therapy
Brittany Craig, Children's Mental Health Program Officer, CMHB, February 17, 2022 at 2pm Mountain Time (1 hour)
Therapy Services 
Laurie Nelson, Therapies Program Officer, DPHHS, March 17, 2022 at 2pm Mountain Time (1 hour)
Nursing Facility
Jenifer Thompson, Nursing Facility Claims Specialist, SLTC, April 21, 2022 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.