Welcome to the Montana Healthcare Programs
Provider Information Website.
Attention: Providers Partnered with Change Healthcare for Electronic Claims Submission to Montana Healthcare Programs
March 27, 2024The 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
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
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
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
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.
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.
Diabetes Prevention Program
Melissa House, Diabetes Prevention Program Officer, DPHHS, April 18, 2024 at 2pm Mountain Time (1 Hour)
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 Mountain Time (1 Hour)
General Resources
Tasha Harris, Provider Relations Field Rep, Conduent, July 18, 2024 at 2pm Mountain Time (1 Hour)
This training will include:
• How to read a remittance advice.
• General website resources.
• How to fill out an individual adjustment request form.
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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