Passport to Health
General Passport Information
Passport Publications
Medicaid Rules/Regulations
Notices and Replacement Pages
Other Resources
Forms
General
Passport Information
What
Is Passport?
Useful information for providers on the Passport to Health Program and
how to obtain Passport approval. Reviewed 2/2008
Passport Q&A
Get answers to the most commonly asked Passport questions. Reviewed 2/2008
Passport
Publications
Passport
Client Handbook
Reviewed 2/2008
Passport
to Health Provider Handbook
Everything providers need to know to become a successful Passport provider.
05/28/09
Passport to
Health Brochure
Passport to Health Program description. Reviewed 2/2008
Archived Passport Newsletters and Other Materials
Medicaid
Rules/Regulations
Administrative
Rules of Montana (ARM)
Reviewed 2/2008
Passport to Health
Waiver
Reviewed 5/2009
Notices
and Replacement Pages
06/10/04
Team Care Program Announcement
Reviewed 2/2008
Passport and Emergency
Services
Other
Resources
Medicaid
Covered Services Chart
An overview of Medicaid covered services with Passport to Health indicators.
Reviewed 2/2008
Forms
Passport
Change Form
Medicaid clients can use this form to change Passport providers. Provider
changes will not take effect until the month following the request. Reviewed
5/2009
Passport
Referral Form
Providers may use this form when providing a referral for their clients
to another provider. Reviewed 5/2009
Passport
to Health Provider Agreement
Providers who wish to become a Passport provider should be an active Medicaid
provider and have primary care within his or her professional scope of
practice. Reviewed 11/2008
Passport to Health Provider
Agreement Attachment C
Amendment to the Passport provider agreement for private group practices.
Updated 10/2008
Passport to Health Provider
Agreement Attachment D
Amendment to the Passport provider agreement to adjust managed care enrollment
caseload limit. Updated 10/2008
W-9 Form
Providers must submit a W-9 form when changing their physical address. Reviewed
2/2008
