Claim Submission

Claim Forms and Electronic Claim submission

Provider Claim Forms and Electronic Submission

Professional Providers

Professional Providers should use the CMS-1500 PDF Document form to be compensated. The CMS-1500 is available at most office supply stores. If you print our online form, you must print it in color so that our optical character scanner can "read" the form.

Hospitals and Facilities

Hospitals and facilities should complete the UB-04 PDF Document claim form to receive compensation for medical services. If you print our online form, you must print it in color so that our optical character scanner can "read" the form.

Dental Providers

Dental providers may use the Blue Cross and Blue Shield of Montana (BCBSMT) Dental Claim Form PDF Document to receive compensation for services.

If the services are provided in Montana submit claims to:

Blue Cross Blue Shield of Montana
PO Box 6227
Helena, MT 59604

View all our Provider Forms.

More claims filing information is published in the BCBSMT Provider Manual.

Claim Submission-Blue on Blue

How should claims be submitted when a member has two coverages with BCBSMT?

When a member is covered by two BCBSMT contracts with different Health Plan identification numbers (HPID), it is called Blue-on-Blue coverage. The claim should be submitted to BCBSMT containing the primary policy HPID. BCBSMT will process the claim on the primary policy and then transfer the claim information to the secondary policy for processing.

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