For any review submitted through the portal, once a decision has been made, a letter will be attached to that review. The letter can be viewed by searching for the review using the Reference ID that was assigned to the case when it was created. Once you have located the review, click on the Reference ID link to open the Case Summary page. On that page, you will see the Reference ID link listed with details about the case letting you know what decision was made and when the decision was made. Click on the Reference ID again to open the Case Details Page. On the Case Details page, you will see a table that contains any letters that have been attached to the case. When you click on the letter, a PDF file will open for you to view and read the letter. This PDF can be printed or saved for your reference.
Providers can access Mountain Pacific’s 24/7 provider portal to check the status of case(s) submitted for review. Details on this functionality will be presented during the portal training sessions.
Providers should upload all clinical documentation through Mountain Pacific’s provider portal. Detailed instructions will be presented during training sessions in March.
Once the new process is fully implemented, providers will be required to submit cases through the portal. Mountain-Pacific will not accept faxed, mailed or emailed requests unless a provider seeks and is granted an exemption from the Montana Department of Public Health and Human Services. If you cannot submit through the portal, please contact the appropriate Medicaid program officer to seek approval for fax or mail submission:
DME: Alesha Horn - 406.444.4518
Physician: Cassie O'Bryant - 406.444.3995
Hospital: Val St. Clair - 406.444.4834
Ambulance: Kelly Aughney - 406.444.4182
PDN: Liz LeLacheur - 406.444.6002
Provider training sessions for using the portal are scheduled for March 27th and March 29th. Registration instructions are posted on the Education and Training tab of this webpage. Additionally, a training session will be recorded and posted in this section for on-demand review.
The following are the only services that should be entered in the portal as part of your prior authorization request:
Base rates
Out-of-town miles (when the pickup point is out of the city limits)
Oxygen
The following services are either not covered or do not need prior authorization. Do not enter these codes into the portal as part of your prior authorization request:
Local (in town/city) miles – Local miles are already included in the base rate for ground transport, unless the pickup point is out of city limits.
Supplies – Gauze, dressings, defibrillation supplies, disposable supplies, etc. Supplies can be billed one time per transport in addition to the base rate, but they do not need prior authorization.
Drugs – Medications, injectable drugs and IV solutions are covered in addition to the base rate when medical necessity is clearly documented. These items also do not need prior authorization.
EKG services – EKG monitoring is included in the base rate.
Generally, registration applications are processed within two to three business days. Please note that if there is a large number of applications received at once, processing may extend to four business days.
Yes. There can be more than one security administrator at each facility. They can manage the users and the NPIs within the organization as it works for their processes
Yes, as long as each person has access to the portal and access to the organization in the portal. One person can start the case and another person with applicable access can log in and add additional documents to the case prior to the case being reviewed. It is important to ensure each person has the access to the system he/she needs and the person who starts the case must set the visibility to anyone with access to the organization.
Using the provider portal does not require the installation of special software. However, Chrome or Firefox is the preferred web browser for accessing the portal. If you have not already done so, you will need to complete and submit a provider registration form. The provider portal is a secure website that allows providers to electronically submit medical authorization requests. This provides a fast and secure turn-around for authorization review. Users may log in to the provider portal to see the status of their authorization requests. Documents can be securely uploaded directly to the authorization request instead of faxing or mailing information which may delay the process.
The following services should be submitted through the portal:
April 1, 2019