Indian Health Services

Provider Manuals (Updated April 25, 2006)
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

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

Indian Health Services
This manual has billing instructions specific to your provider type.
04/2006

Passport to Health Provider Handbook
Everything providers need to know to become a successful Passport provider.
09/2005

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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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Notices and Replacement Pages
08/12/08
Federal Government May Request Medical Records

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

03/10/08
NPI Reenrollment and Billing

02/20/08
Changes to Prior Authorization for Circumcision - Updated August 5!

02/19/08
New HCPCS/CPT Codes

02/13/08
Tamper-Resistant Prescription Pads

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

01/11/08
Vaccines for Children (VFC)

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®

10/03/07
VFC Update

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

04/18/06
VFC Update

03/01/06
VFC Update

02/10/06
New and Deleted Codes

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

04/11/05
Dental Program Coverage Changes

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

06/01/04
Important Reminder Regarding Sterilizations, Hysterectomies and Abortions

02/01/04
New and Deleted Codes

01/01/04
VFC Changes - Updated from December!

12/01/03
VFC Changes

12/01/03
Discontinued Local Codes

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 and Physician Manual Replacement Pages

06/01/03
Discontinued Services That Now Require Prior Authorization

02/03/03
New Billing Requirements for UB-92 Billers

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

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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
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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