New Provider Information:
Welcome New Providers and Billers!
Now that you have enrolled as a Montana Healthcare Programs provider, there are a few things you will need to know about how to get claims submitted and paid.
Please follow these steps for successful claim submission:
a. Choose and click on your provider type.
b. Bookmark your provider type page.
c. Make sure you are using resources specific to your provider type. Although pages may appear to be similar each provider type has different information and forms.
The provider type page contains manuals, provider notices, fee schedules, and resources specific to your provider type. Be aware of your specific provider type requirements regarding all documents. Documents such as fee schedules and manuals change constantly and provider notices can be issued at any time.
d. Review recent provider notices and fee schedules on your provider type page.
e. When reviewing documents such as the manuals, fee schedules, and provider notice take notice of requirements necessary PRIOR TO providing services. For example, look for age limits, dollar limits, prior authorization, and passport referral number. Re-check the fee schedule prior to delivering a service.
f. Download and read the general manual, the manual specific to your provider type, and any additional manuals in the Manuals panel of the provider type page.
Note: Providers and billers do not need to print out the manual. Manuals are updated regularly as Federal and State laws and procedures change.
Always reference the current manual online.
2. Register for the Montana Access to Health Web Portal (aka MATH).
a. The MATH Web Portal is where you check the status of a claim, eligibility of a member before rendering services, and download remittance advices.
b. To access the MATH Web Portal visit the provider website home page. You will need your credential letter to register, as explained in the Registration Tutorial. The link is in the left menu. Once in the portal, choose "Web Registration".
3. Sign up to bill electronically.
a. Find out how on the Claims Instructions page. Access the Claims Instructions button from the home page on the Provider Website.
4. DPHHS recommends providers check the general eligibility of any member before rendering services. This can be done by checking:
a. Montana Access to Health (MATH) Web Portal
b. Calling Integrated Voice Response (IVR): (800) 362-8312
c. Receive Faxback: 1(800) 624-3958 Option 1, Option 2
d. Call 1(800) 624-3958
5. The majority of members are also Passport members.
a. When checking eligibility also check to see if the member is a Passport member. If so, contact the indicated Passport Provider PRIOR to rendering service to obtain a Passport referral number, a Passport referral number is required if the eligibility indicates the member is enrolled and the service requires a passport referral.
b. Learn more about how the Passport program and how to obtain Passport provider approval on the Passport page of the provider website.
6. Read recent Announcements and Claim Jumper Newsletters.
a. Register to receive Claim Jumper Newsletters with important updates and urgent announcements.
b. The most recent announcement is on the home page.
c. Other current announcements are found on the Announcements page.
d. Prior issues of the Claim Jumper are on the Claim Jumper Newsletters page.
7. Register for Trainings and Webinars.
a. Access the Training and Events page from the button on the home page of the Provider Website.
b. Trainings are held throughout the state twice per year. Webinars addressing critical issues are held approximately one time per month.
8. Ensure your CMS and Montana State Level Registry is current.
a. The Electronic Healthcare Record (EHR) provides incentive monies to eligible providers and hospitals.
b. Learn about the program and how to register and apply by visiting the Montana EHR page of the DPHHS website.
A Provider Relations Field Rep is always available to answer questions and help you navigate the claims process. Email the Field Rep at firstname.lastname@example.org.
Correspondence, claims processing, and any updates to your file are handled by Conduent on behalf of Montana DPHHS. If you cannot access the website, if you have any questions, or if you have problems with billing matters or claims, please contact our Provider Relations at 1(800) 624-3958 or (406) 442-1837.