- 09/03/2013 Passport to Health Member Pending Lists and Provide Caseload Capacities
- 02/13/2012 Emergency Room Update Including Passport
- 07/05/2013 Medicaid/HMK Plus and Sports Physicals
- 05/06/2013 Passport to Health Disenrollment Requirements for Providers Disenrolling a Member
- 02/11/2013 Passport and Medical Evaluation with Psychotherapy Services
- 05/01/2012 Passport and Foster Care
Improvement Program Provider Referral Form (10/2014)
Providers should fill out this form and fax it to the 406-444-1861.
- Passport Agreement Amendment to Add Providers (08/2013)
Providers should fill out this amendment to the Passport provider agreement when adding new providers to a group practice.
- Passport Agreement Amendment to Increase Caseload Capacity (08/2013)
Providers should fill out this amendment to the Passport provider agreement when increasing member caseload capacity.
Change Form (07/2014)
Medicaid/HMK Plus members can use this form to change Passport providers. Provider changes will not take effect until the month following the request.
Referral Form (07/2013)
Passport providers may use this form when providing a referral for their members to another provider.
- Passport to Health Provider Agreement (02/2014)
Providers who wish to become a Passport provider should be an active Medicaid provider and have primary care within his/her professional scope of practice. This agreement is section of the overall Montana Health Care Programs enrollment package and the page numbering reflects that document.
- W-9 Form (12/2011)
Providers must submit a W-9 form when changing their physical address. This is the approved form to use.
- Passport to Health Waiver (Reviewed 07/2012)