Rural Health Clinic
Provider Manuals (Updated August 24, 2007)
Medicaid Rules/Regulations (Updated May 9, 2006)
Notices and Replacement Pages (Updated August
12, 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
Rural Health Clinic
This manual has billing instructions specific to your provider type.
08/2007
Prescription Drug
Prior Authorization
Prior authorization requirements and procedures are covered in this
manual.
11/2004
Passport
to Health Provider Handbook
Everything providers need to know to become a successful Passport provider.
09/2005
Medicaid
Rules/Regulations
Administrative
Rules of Montana (ARM)
Montana
Code Annotated (MCA)
Code
of Federal Regulations (CFR)
Notices
and Replacement Pages
08/12/08
Federal
Government May Request Medical Records
07/11/08
Changes in
Mental Health Services Plan for Adults Age 18 and Older
05/22/08
Frequently
Asked Questions About NPI Reenrollment and Billing -
Updated June 17!
05/01/08
RHC/FQHC Taxonomy
on Provider Encounters in Hospitals
03/10/08
NPI Reenrollment
and Billing
02/19/08
New HCPCS/CPT
Codes
02/13/08
Tamper-Resistant
Prescription Pads
01/28/08
Expansion
of Provider Types for the Mental Health Services Plan
01/18/08
Possible
Duplicate Claims Processed Through Electronic Data Interchange
01/11/08
Vaccines for Children
(VFC)
12/28/07
New Codes for
Smoking and Tobacco Use Cessation Counseling
12/27/07
2008 Rate Increase
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
12/03/07
NPI Requirement
for Institutional 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®
10/31/07
RHC Services in Hospitals
10/16/07
Smoking and Tobacco
Use Cessation Counseling
10/03/07
VFC Update
10/01/07
Attending Provider
09/28/07
Smoking and Tobacco
Use Cessation Counseling
08/09/07
NPIs Will Be Required
for Attending Providers
08/01/07
Elimination
of ESOR
07/06/07
Coverage of
17 Alpha-Hydroxyprogesterone Caproate
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
04/16/07
VFC Update-
Updated from January 24!
04/16/07
Coverage of
HPV Vaccine
03/08/07
New and Deleted Codes
01/18/2007
Admit Hour to
Be Required for Institutional Claims
09/22/06
VFC Update
06/30/06
Revenue
Code Changes Effective July 1
04/18/06
VFC Update
03/01/06
VFC Update
02/24/06
Passport Required
for FQHCs, RHCs and Home Health
02/10/06
New and Deleted Codes
10/05/05
Reimbursement
Rates of Increase or Decrease in Scope of Service
07/28/05
Scales - Congestive
Heart Failure
07/01/05
Revised Processing
for Emergency Room Visits
07/01/05
VFC Update
06/01/05
Medicaid Coverage
Update
04/29/05
General Manual
Replacement Page - Member Number a Billable Number and Key Contacts
Updated
03/01/05
Hysterectomy Acknowledgement
Update
02/04/05
Introduction to
Preferred Drug List
02/01/05
New and Deleted Codes
and New Botox Criteria
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
06/10/04
Prescription Drug
Prior Authorization Additions
06/10/04
Team Care Program
- A New Component of the Passport to Health Program
02/01/04
New and Deleted
Codes
01/01/04
VFC Changes
10/17/03
Q & A Regarding
Reporting ICD-9-CM Procedure Codes
10/14/03
Form Locator Update
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
07/31/03
Passport and Emergency
Services
07/28/03
Hysterectomy Requirements
03/01/03
Pharmacy Prior Authorization
and Refill Changes
02/03/03
New Billing Requirements
for UB-92 Billers
01/29/03
Prescription Drug
Update
01/15/03
Dental Program Changes
01/10/03
New Provider
Notification Procedure and Medicaid Changes
01/02/03
Drug Prior Authorization
Changes
10/07/02
Presumptive Eligibility
10/01/02
Billing for Medicare
Crossovers after Medicare's 45 Day Response Time
09/01/02
Cost Sharing
06/20/02
Passport to Health
24-Hour Availability
03/21/02
Prior Authorization
Reminders: DME, DMEPOS
02/22/02
Payment Methodology
Change - Updated 04/21/06
02/14/02
Weekly Payment
Available
05/29/01
Billing for Lab
Panels
05/09/01
Billing for Abortion
Services
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
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.
Key
Contacts
RHC
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
