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MONTANA DPHHS Montana Medicaid Provider Site Search Supplemental Payments Contact Us COVID-19 Provider Information Online Services MATH Web Portal Provider Services Portal Provider Locator Search Resources by Provider Type Provider Enrollment Subscribe to Claim Jumper Site Search Site Index Announcements Archive Claim Instructions Claim Jumper Newsletters Contact Us Covid-19 Provider Information Definitions and Acronyms Drug and Pharmacy News Electronic Billing EOB R&R Crosswalk Excel EOB R&R Crosswalk PDF EPSDT FAQs Forms Medicaid Expansion and HELP Plan HIPAA 5010 ICD-10 Information MATH Web Portal Medicaid Statistics Medicaid Fraud and Abuse Member Information New Provider Information Offices of Public Assistance (OPA) Passport to Health Password Reset Instructions Plan First Preferred Drug List Presumptive Eligibility Prior Authorization Information Proposed Fee Schedules Provider Enrollment Provider File Updates Provider Locator Search Provider Specialty Table Rebateable Manufacturers Recent Website Posts Resources by Provider Type RBRVS Supplemental Payments Team Care Terminated/Excluded Medicaid Providers Training and Events Vaccines for Children Welcome to the Montana Healthcare Programs Provider Information Website. Provider Services Portal COVID-19 Provider Information and Notices Attention: Providers Partnered with Change Healthcare Can Resume Electronic Claims Submission to Montana Healthcare Programs May 9, 2024 Change Healthcare has re-established their connection with Montana Healthcare Programs. Providers can resume sending claims via their standard practice prior to the Change Healthcare cyberattack. If you are submitting claims and continue to experience issues, please reach out through your biller to connect with the Change Healthcare resources. For more information, please see reference to Montana Medicaid at https://www.unitedhealthgroup.com/changehealthcarecyberresponse#latestupdates. Attention: Providers Partnered with Change Healthcare for Electronic Claims Submission to Montana Healthcare Programs March 27, 2024 The MPATH Provider Services module allows for the upload of HIPAA compliant X12 files in lieu of submitting through a Clearinghouse if the billing software has export functionality. To access this feature, log in to MPATH Provider Services and click Bulk HIPAA Transactions” on myMenu. From the File transaction activity screen, click Upload, Select File Type Claim Submission (837), click Browse and Locate and select the file to be uploaded, and click the Upload button. Supported file types are .edi and .bil. Remit Advice Issues March 12, 2024 We have resolved the issue that was causing remits to appear duplicated. Please recheck the MATH or MPATH portal for your correct Remittance Advice. If you experience further issues, please contact Provider Relations if there are questions or concerns at (800) 624-3958, or MTPRHelpdesk@conduent.com Attention: Providers Partnered with Change Healthcare for Electronic Claims Submission to Montana Healthcare Programs February 26, 2024 Providers impacted by the Change Healthcare cyberattack can use the DPHHS Provider Services portal to submit claims to Montana Healthcare Programs. For more information on using the portal, please visit the Billing 101 Training . For more information on the Change Healthcare cyberattack please visit the Change Healthcare Incidents page . Dental Remittance Advice Formatting Error January 19, 2024 Beginning on payment cycle 12/14/2023 Dental Remittance Advices were updated to display tooth number and/or surface at the line level claim detail. The change resulted in formatting errors causing claim lines to span across one or more pages making reconciliation more difficult. The Department is actively working with Conduent to correct the formatting error. 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. 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. Online Training Available 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. SURS Nuts and Bolts Jen Tucker, SURS Supervisor, DPHHS, May 16, 2024 at 2:00pm to 3:00pm Mountain Time (1 Hour) Billing 101 Tasha Harris, Diabetes Prevention Program Officer, DPHHS, June 20, 2024 at 2pm...