Claim Forms and Electronic Claim Submission
Provider Claim Forms and Electronic Submission
Availity® Essentials – To register with Availity or learn more about services available to BCBSMT providers, visit the Availity website, or call Availity Client Services at 800-AVAILITY (282-4548). Have additional E-Commerce questions? Contact our Electronic Commerce Center by emailing ecommerceservicesMT@bcbsmt.com.
- Other online options of Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT) are also available.
- For specific claims questions, please refer to the Contact Us page.
Professional Providers should use the CMS-1500 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 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 may use the Blue Cross and Blue Shield of Montana (BCBSMT) Dental Claim Form to receive compensation for services.
If the services are provided in Montana submit claims to:
Blue Cross Blue Shield of Montana
PO Box 660247
Dallas, TX 75266-0247
More claims filing information is published in the BCBSMT Provider Manual.
- NDC Billing Guidelines
- NDC FAQs
- Submitting Electronic Replacement or Voided Claims
- Urine Drug Testing Documentation Guidelines
- Annual Health Assesments Documentation & Coding Tips
- Asthma Documentation & Coding Tips
- Atrial Fibrillation Documentation & Coding Tips
- Cancer and Cancer Related Treatment Documentation & Coding Tips
- Diabetes Mellitus Documentation & Coding Tips
- Human Papillomavirus Documentation & Coding Tips
- Hypertension Documentation & Coding Tips
- Major Depressive Disorder Documentation & Coding Tips
- Mental Disorders Documentation & Coding Tips
- Obesity Documentation & Coding Tips
- Vascular Disease Documentation & Coding Tips