Montana End User Online Services Terms and Conditions

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US-CP0829-AM
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This sample form, a detailed End User Online Services Terms and Conditions document, is for use in the computer, internet and/or software industries. Adapt to fit your circumstances. Available in Word format.
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FAQ

For answers to all claims questions, call Provider Relations at (406) 442-1837 or 1 (800) 624-3958.

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.

If you are dissatisfied with an agency decision you may appeal the decision in writing to: The Department of Public Health and Human Services (DPHHS) Hearing Officer, PO Box 202953, Helena, Montana 59620, or telephone, 406-444-2470 (Voice/TDD) within 45-days of the date you are notified of the decision.

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.

There are two ways to submit claims to the Montana Healthcare Programs: Electronic and paper. Electronic claims are processed an average of 14 days faster than paper claims. Paper claims submitted via mail are processed an average of 12 days faster than paper claims submitted by fax.

Refer to the NPI claims instructions on the Provider Information website to determine the reason your claims are denying, then correct and resubmit them within the 365-day timely filing limit.

How do I report a change? You can call us at 1-888-706-1535, stop by a local OPA office, mail a letter to PO Box 202925 Helena MT 59620-2925, fax us at 1-877-418-4535, or create an online account at apply.mt.gov. You can report changes in address only here.

Approximate Monthly Income to Qualify for Montana Medicaid, 2023 Family SizeAdults 19-64Pregnant Women1$1,616$1,9082$2,186$2,5803$2,749$3,2454$3,325$3,9252 more rows

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Montana End User Online Services Terms and Conditions