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If you have questions on which enrollment type is appropriate for you, contact Provider Relations at (800) 624-3958 or email MTEnrollment@conduent.com.
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.
Montana has a 60-month (5 year) Medicaid Look-Back Period that immediately precedes one's application date for Nursing Home Medicaid or a Medicaid Waiver. During the ?look back?, Medicaid checks all past asset transfers to ensure none were sold or gifted for less than fair market value.
Visit the Montana Healthcare Programs Provider Information website to access your provider type page. Choose Resources by Provider Type in the left-hand menu.
In Montana, the Medicaid spend-down does not cover Long Term Services and Supports (LTSS). Income eligibility: The income limit is $525 a month for both single and married applicants. Asset limits: The asset limit is $2,000 if single and $3,000 if married.
Some services may require both Passport referral and prior authorization. If a service requires prior authorization, the requirement exists for all Medicaid members. Prior authorization is usually obtained through the Department or a prior authorization contractor.
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.
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.