Get MT DPHHS Authorization For Release Of Information

For electronic claims, the 160-M can either be faxed to 406.442. 4402 with the appropriate Paperwork Attachment Cover Sheet or mailed with the same cover sheet to Claims, P.O. Box 8000, Helena, MT 59604.

Need help finding your local Office of Public Assistance, Enrolled Medicaid Provider, or Passport Provider? Call Montana Healthcare Programs, Member Help Line 1-800-362-8312, M-F, 8am-5pm, for assistance. Find a Montana Medicaid Provider.

Montana generally prohibits health care providers from disclosing a patient's health care information. There are important exceptions, however. Patients can authorize disclosure of health care information.

Generally, an authorization provides the authority for a doctor's release of PHI for specified purposes, which are generally other than treatment, payment, or healthcare operations, or, to disclose protected health information to a third party specified by the individual.

Montana's Medicaid program provides Montanans with low-incomes access to health care benefits and services based on their medical needs and life circumstances. Its Healthy Montana Kids program is the largest provider of health care for children in the state.

Who is eligible for Montana Medicaid? Household Size*Maximum Income Level (Per Year)2$19,7203$24,8604$30,0005$35,1404 more rows

Public Health and Human Services General Information (406) 444-5622 111 North Sanders Helena, MT 59601-4520 PO Box 4210 Helena, MT 59604-4210 Department of Public Health and Human Services Organizational ChartFAX Number(406) 444-1970Websitedphhs.mt.govQuick Lookup:172 more rows

Montana first enacted this policy for children covered under Medicaid/HMK. Since the start of Medicaid expansion in 2016, Montana's Medicaid program has had a policy of 12-month continuous eligibility for most adults receiving healthcare coverage.