Provider Connection
Payment and Billing Questions
June 19, 2015
When requesting a re-evaluation or reconsideration of denied payment you must submit the following documentation to us in the order listed:
- A copy of the denial EOR
- Corrected CMS 1500 or UB04 (if applicable) with “Corrected Claim” written on billing form
- Additional documentation or information (if applicable)
Submit re-evaluation or reconsideration requests by mail:
Montana State Fund
PO Box 4759
Helena, MT 59604
By Fax
406-495-5020
Calling for Bill Status Information?
Dial 1-877-591-8028. To expedite the call please have the following information available.
- Claim number
- Provider tax ID number
- Date of Service
- Billed amount
