NEW PROVIDER ENROLLMENT OR EXISTING PROVIDER REENROLLMENT

Eligibility
Covers how clients qualify for Montana Health Care Programs.

Billing Basics takes a more in-depth look at using resources on the Montana Health Care Programs website and navigating the Montana Access to Health (MATH) web portal.

During the course, we will discuss claim denials, use the resources available to interpret the reason and remark codes, and solve the mystery of why a claim denied.

This course also includes electronic claims information with a focus on 5010 changes and CyberAccess.

SURS reviews paid claims for Medicaid services to verify compliance with program policies as well as State and Federal Laws. Covers audit types and how they progress.

Hospitals, FQHCs, and RHCs
The 340B presentation provides an overview of the 340B program, who is eligible, benefits and drawbacks, estimated savings, helpful websites for additional information, and an opportunity for questions

The FQHC, dialysis, and ASC presentation provides an overview of recent CMS changes, the effects these changes have on programs, and other updates as requested.

Additional presentations include a Present on Admission (POA) update regarding Department system changes, prior authorization requirements for services and contact information, and how to bill correctly for claims where the client has partial eligibility.

Includes detailed discussion of Prospective Payment System for FQHCs and RHCs and explanation of Presumptive Eligibility (now offered to uninsured children statewide through participating facilities).

• Correct claim forms
• Procedure codes
• Multiple visits
• IHS pharmacy recap
• Biweekly conference calls
• MAM Program review updates
• Provider Type 57 versus other types (e.g., PCA)
• Question/Answer session

Participants discuss prior authorizations, nursing facility claim reviews, facility reporting requirements (i.e., Monthly Nursing Home Staffing Report, Hospital Holds, THV Requests, and Nurse Aide Testing and Training).

School-Based Services
This course concentrates on School-Based services available with Montana Medicaid.

The services include Therapies, Private Duty Nursing, Personal Care, and Transportation for children on Individual Education Plans or IEPs that are in Special Education.

Includes discussion on coding tips and claim submission as well as finding client eligibility.

Other topics of discussion include Child Profile forms, Task Hour Guides for Personal Care, and the recently changed Medicaid Administrative Claiming (MAC) program, and includes a discussion of those changes and details on problems that continue to occur.

Home- and Community-Based Services
No description available at time of posting.

Electronic Health Records (EHR)
This course covers what EHR is, how the program works, and who qualifies for participation. Includes discussion on Federal rules and registration process as well as information about who to contact, incentive money, and milestones achieved to date.

Adult Mental Health
This Mental Health Services Bureau presentation includes adult services, with information on the Mental Health Services Plan, Medicaid, Basic Medicaid Waiver, HCBS Waiver, submitting claims, and ‘claims forcing’.

Dental
Join this training session to expand your knowledge base on HMK Plus/Medicaid Dental for ages 0-999. You will be updated on new rules and policies and reminded about old rules and policies. Review fail-safe methods to get your claims paid. Learn why we pay the rate we pay and finally, data to prove it! I look forward to meeting you in person by having you join my session.

Transportation
Join this training session to expand your knowledge of Medicaid transportation services. You will be updated/reminded of current rules and policies. Review methods to maintain records. We look forward to meeting you in-person by having you join our session. This session will be lead by Jan Paulsen, Program Officer and Mary Hooks, Call Center Administrator.

Children's Mental Health
Jamie Olsen Stolte will give a brief description of state-funded mental health services for children under age 18.

The presentation provides an overview of all mental health programs administered through the Children's Mental Health Bureau (CMHB) which is mostly funded by Medicaid.

In addition, the presentation provides an overview of recent changes in the CMHB system and progress towards CMHB’s vision to build an integrated system of care for programs serving Montana families, youth, and children.

The course covers crossovers, coverage, eligibility, claim form completion, and paperwork attachments.

SURS reviews paid claims for Medicaid services to verify compliance with program policies as well as State and Federal Laws. Covers audit types and how they progress.

Managed Care
This session provides an overview of the Passport to Health, Team Care, Health Improvement, and Nurse First programs. These programs are all focused on bringing the best care coordination and assistance to clients in a medical home setting. The session helps you understand the goals and rules for each program and give you the opportunity to ask questions of and receive contact information for Program Officers.