November 9, 2022
Blue Cross and Blue Shield of Montana (BCBSMT) has implemented an Interactive Voice Response (IVR) automated phone system for providers to verify the patient’s eligibility and benefit details, submit and/or check status for prior authorization requests, and request claim adjustments.
The IVR provides you quick access to needed information without waiting to speak with a Customer Advocate. You also have the option to use your touch tone keypad to enter alpha-numeric characters and receive a faxed confirmation of the IVR quote.
Obtaining Eligibility and Benefits and Requesting Claim Adjustments
- Eligibility and benefit quotes include membership verification, coverage status and other important information, such as applicable copayment, coinsurance, deductible amounts, and code-specific prior authorization requirements.
- To request a commercial claim adjustment, the document control number (claim number) is required when calling the IVR to connect with a Customer Advocate for assistance. General claim status is not available in the IVR, but can be quickly obtained online using the , or the web vendor of your choice.
The IVR phone system is accessible by calling 800-447-7828 Monday through Friday, 5 a.m. to 10:30 p.m., MT, and Saturday, 5 a.m. to 5 p.m., MT.
Requesting Prior Authorization
When BCBSMT requires the service to be preauthorized, you can initiate the request and/or check the status by calling the prior authorization IVR phone system at 855-313-8914 Monday through Friday, 5 a.m. to 10:30 p.m., MT, and Saturday, 5 a.m. to 5 p.m., MT.
Resources and Assistance
Caller Guides are available on our provider website, which provide step-by-step instructions and helpful navigation tips. To view the Caller Guides and more helpful information please visit the BCBSMT provider website. Interactive Voice Response (IVR) System
If you need further assistance, email our Provider Education Consultants.
- For out-of-state Blue Cross and Blue Shield members, call the BlueCard® Eligibility Line at 800-676-BLUE (2583). Learn more about BlueCard.
- Federal Employee Program® (FEP®) eligibility and benefits can be obtained by calling 800-634-3569, and for services requiring prior authorization call 877-885-3751.
- Healthy Montana Kids eligibility and benefits can be obtained by calling 855-258-3489, and for services requiring prior authorization call 855-699-9907.
- For government programs member information, eligibility verification, as well as prior authorization can be obtained by calling Blue Cross Medicare AdvantageSM – Individual: 877-774-8592 and Group: 877-299-1008.
Checking eligibility and/or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSMT. BCBSMT makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.