Claims for specific services will be administered by the Montana Department of Health and Human Services (DPHHS), while others will be administered by BCBSMT.
Services for which DPHHS will administer and pay the claims:
- IHS and tribal health services
- Diabetes prevention services
- Any transportation
- Prescription drugs
- Home infusion
- Hearing aids
Submit hard copy claims to DPHHS at the following address:
P.O. Box 8000
Helena, MT 59604
Excluded provider types/services include:
- Naturopathic physicians
- Nursing homes
- Inpatient hospice
- Long Term Care
- Chronic care institutions
Submit hard copy claims to BCBSMT at the following address:
BCBSMT HELP Medicaid Claims Correspondence
P. O. Box 3387
Scranton, PA 18505
The Provider Electonic Payor ID for the HELP Plan is - 66004
The HELP Plan Alpha Prefix is YDM
The HELP Plan will use Claims Extend bundling
Eligibility & Benefits Requests (270) and Claim Status Inquiries (276) for dates on or after 1/1/16 can now be submitted electronically using Payer ID BCBMT and the subscriber ID should include the 3 character alpha prefix (YDM) followed by the numeric member ID/Medicaid ID. If you have any questions, please contact HeW Support at 1-877-565-5457, Option 1.
Providers can also enroll to receive Electronic Remittance Advices (ERA) and Electronic Funds Transfers (EFT) for this payer. Effective 6/17/16, all BCBSMT providers already receiving ERAs and EFTs were automatically enrolled to receive the ERA and EFT for this new payer and no additional enrollment is necessary. If you are not currently receiving ERAs/EFTs and would like to enroll, please contact HeW Support at 1-877-565-5457, Option 1.
For newborn babies, please hold claims until the baby is set up with standard FFS Medicaid. Claims will not process under the mother. The newborn 31 day rule is state statute and does not apply to Medicaid or the HELP Plan.
BCBSMT allowances for services mirror the Montana Medicaid fee schedules .