Update: Change In Advance Member Notification Process July 15, 2020

May. 12, 2020

To improve cost transparency for our Members and provide a more efficient process for our Participating Providers, Blue Cross and Blue Shield of Montana (BCBSMT) has updated our Advance Member Notification (AMN) process.

These changes applied to all lines of BCBSMT business except for Medicare Supplement, Medicare Advantage, and Federal Employee Program effective 1/1/2020.

The AMN process has now been expanded to include Experimental, Investigational, and Unproven (EIU) services, supplies, drugs, or devices effective 7/15/2020.

For complete information please review the Provider Compensation Policy available on the Secure Provider Portal.

What is Advance Member Notification?

AMN refers to the process in which a BCBSMT Participating Provider informs a BCBSMT Member that a service, supply, device, or drug may not be a Medically Necessary covered service or may be EIU prior to the service being performed.

Participating Providers agree they will not bill Members for services BCSBMT denies as not Medically Necessary or EIU. However, through the AMN process, the Member may make an informed decision to assume potential financial responsibility for the service if the Member chooses to proceed with the service. With an appropriately completed AMN form for the specific services, the Participating Provider can bill the Member for services denied as not Medically Necessary or EIU.

For questions, please contact your Provider Network Consultant.