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For Providers
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May 2025 |
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MAY SPOTLIGHT |
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Reinforce Prenatal and Postpartum Care to Support Whole Health
We track quality measures related to our members’ care visits and depression screening during and after pregnancy. Review tips to close gaps in care.
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CLAIMS AND ELIGIBILITY |
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Take Note of Prior Authorization Changes for Commercial and Government Programs
Effective July 1, 2025, prior authorization requirements for certain commercial and government plans are changing to reflect new, replaced or removed codes.
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EDUCATION |
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Explore Learning Opportunities
We offer free training for providers who participate in our networks. Sign up for sessions, including coding webinars that offer continuing education units.
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NETWORK PARTICIPATION |
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Payment Error Rate Measurement Program Identifies Common Medicaid Claims Errors
The Centers for Medicare & Medicaid Services’ PERM program measures improper payments for Medicaid and the Children’s Health Insurance Program to produce national error rates. See common errors identified by the program.
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PHARMACY |
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Pharmacy Program Quarterly Update – Part 2
Changes were made to our drug lists and utilization management program. Learn about these and other pharmacy program updates.
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STANDARDS AND REQUIREMENTS |
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Review Medical Policy Updates
Approved new or revised medical policies and their effective dates are usually posted on our website the first and 15th of each month. You can view all active and pending policies, as well as draft medical policies, and provide comments on draft policies. These policies may impact your reimbursement and your patients’ benefits.
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Contact Us
Contact information for Network Representatives and other resources is on our website.
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Blue Cross and Blue Shield of Montana, a Division of Health Care Service Corporation,
a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
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3645 Alice St., Helena, MT 59601
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