Denturist

Provider Manuals (Updated July 7, 2005)
Medicaid Rules/Regulations (Updated May 9, 2006)
Fee Schedules (Updated February 19, 2008)
Notices and Replacement Pages (Updated June 17, 2008)
Other Resources (Updated January 2, 2008)
Remittance Advice Notice
Key Contacts (Updated March 1, 2007)

Provider Manuals
General Information For Providers
Medicaid billing manual with general information for all provider types.
04/2005

Dental and Denturist Services
This manual has billing instructions specific to your provider type.
07/2005

Prescription Drug Prior Authorization
Prior Authorization requirements and procedures are covered in this manual.
11/2004

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Medicaid Rules/Regulations
Administrative Rules of Montana (ARM)
Montana Code Annotated (MCA)
Code of Federal Regulations (CFR)

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Fee Schedules
Current Fee Schedule in PDF Format
01/2008

Current Fee Schedule in Excel Format
01/2008

Previous Fee Schedule in PDF Format
10/2007

Previous Fee Schedule in Excel Format
10/2007

Previous Fee Schedule in PDF Format
01/2007

Previous Fee Schedule in Excel Format
01/2007

Previous Fee Schedule in PDF Format
07/2006

Previous Fee Schedule in Excel Format
07/2006

Previous Fee Schedule in PDF Format
07/2005

Previous Fee Schedule in Excel Format
07/2005

Previous Fee Schedule in PDF Format
01/2004

Previous Fee Schedule in Excel Format
01/2004

Previous Fee Schedule in PDF Format
07/2003

Previous Fee Schedule in Excel Format
07/2003

Previous Fee Schedule in PDF Format
01/2003

Previous Fee Schedule in Excel Format
01/2003

Previous Fee Schedule in PDF Format
07/2001

Previous Fee Schedule in Excel Format
07/2001

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Notices and Replacement Pages
05/29/08
When to Submit an NDC (National Drug Code) If You Are Billing as a 340B Provider

05/22/08
Frequently Asked Questions About NPI Reenrollment and Billing - Updated June 17!

03/17/08
Resubmission of Denied Claims - Updated March 19!

03/10/08
NPI Reenrollment and Billing

02/04/08
Duplicate Issue

01/18/08
Possible Duplicate Claims Processed Through Electronic Data Interchange

12/17/07
Enhanced Claims Editing—Assistant / Team / Co-Surgeon

12/17/07
Enhanced Claims Editing—Multiple Evaluation and Management Services Provided on the Same Day

12/06/07
Dental Rates and Claim Forms

12/04/07
NPI Requirement for Fee-for-Service Healthcare Provider Claims

11/27/07
Cost Share Changes

11/01/07
Enhanced Claims Editing—Add-on Codes

11/01/07
Enhanced Claims Editing—New Visit Evaluation and Management Codes

11/01/07
Enhanced Claims Editing—Bloodhound ClaimsGuard®

08/01/07
Elimination of ESOR

06/25/07
NPI on the Web Portal

06/11/07
Ownership and Control Information Required for Reenrollment

06/06/07
NPI Contingency Plan Implemented, Reenrollment Extended

05/31/07
New CMS-1500 to Be Required Beginning July 2, 2007

07/28/05
Scales - Congestive Heart Failure

07/01/05
Dental Manual Repacement Pages - Updated Fees

04/29/05
General Manual Replacement Page - Member Number a Billable Number and Key Contacts Updated

04/11/05
Dental Program Coverage Changes

02/04/05
Introduction to Preferred Drug List

11/05/04
General Manual Replacement Pages - References to Medicaid Rules/Regulations Added

09/16/04
General Manual Replacement Pages - Team Care and Nurse First Information Added

09/02/04
Dental Manual Replacement Pages - Added "Per Quadrant" Requirements to Codes D4240-D4261

07/01/04
Dental Manual Replacement Pages - Covered Services Update

07/01/04
Dental and Denturist Code Changes and Manual Update

06/10/04
Prescription Drug Prior Authorization Additions

06/10/04
Team Care Program - A New Component of the Passport to Health Program

12/01/03
Billing Other Health Insurance Before Medicaid

11/07/03
Dental Manual Replacement Pages - Procedures Limits and Requirements

08/29/03
Passport to Health Implementation in Prairie County

08/29/03
DMEOPS Advisory Workgroup Openings

08/20/03
Submitting HIPAA Compliant Claims - Information for All Providers

07/02/03
Manual Replacement Pages - Procedure Limits and Requirements Table

06/08/03
Local Codes Terminated

05/12/03
Provider Rate and Payment Update

03/01/03
Pharmacy Prior Authorization and Refill Changes

02/06/03
Billing With CDT-4 Dental Codes

01/26/03
Prescription Drug Update

01/15/03
Dental Program Changes

01/14/03
CHIP Dental Replacement Page

01/10/03
New Provider Notification Procedure and Medicaid Changes

01/02/03
Drug Prior Authorization Changes

10/01/02
Billing for Medicare Crossovers after Medicare's 45 Day Response Time

09/01/02
Cost Sharing

07/01/02
Dental Program Changes

07/01/02
Replacement Pages

07/01/02
2.6% Reduction

02/14/02
Weekly Payment Available

11/14/01
Tooth Number Required for D1510 and D1515

10/17/01
Dental Implants

06/01/01
Global Surgery Period Billing

03/20/00
Global Surgery Period Billing

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Other Resources
2008 Medicaid Payment Schedule
Medicaid claims payment schedule for 2008
01/2008

Self Audit Policy and Procedure
06/2007

Carrier ID List
TPL insurance carriers listed by carrier ID
06/2007
Carrier ID List
TPL insurance carriers listed by name
06/2007

EOB R&R Crosswalk in PDF format
EOB R&R Crosswalk in Excel format
With the implementation of HIPAA, Medicaid will discontinue the use of Medicaid EOB codes and begin using HIPAA standard reason and remark codes (R&R) . This document crosswalks the HIPAA standard R&R codes to the Medicaid EOB codes.
01/26/04

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Remittance Advice Notice
Your current RA message is as follows:

New 1099 Process
December 14, 2006

Medicaid providers will see a change in the 1099s received for 2006 reporting Medicaid payments. Effective for calendar year 2006 and forward, ACS will no longer be generating and mailing a separate 1099 for Medicaid payments. The Department of Administration will be combining all payments by tax identification number into one 1099 instead of a separate 1099 for each Medicaid provider number. If you have any questions, please contact Roy Hinman at (406) 444-5932 or Susan Austad (406) 444-4060 at the Department of Public Health and Human Services.

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Key Contacts
Dentist/Denturist
08/2002

CHIP
08/2002

Claims
08/2002

County Offices
01/2005

Eligibility
05/2006

Passport
07/2006

Policy Information
07/2006

Prior Authorization
03/2007

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(Updated June 17, 2008)