Claim Submission

Claim Forms and Electronic Claim Submission

Provider Claim Forms and Electronic Submission

Availity® Essentials – To register with Availity or learn more about services available to BCBSMT providers, visit the Availity website, or call Availity Client Services at 800-AVAILITY (282-4548). Have additional E-Commerce questions? Contact our Electronic Commerce Center by emailing ecommerceservicesMT@bcbsmt.com.

Professional Providers

Professional Providers should use the CMS-1500 form to be compensated. The CMS-1500 is available at most office supply stores. If you print our online form, you must print it in color so that our optical character scanner can "read" the form.

Hospitals and Facilities

Hospitals and facilities should complete the UB-04 claim form to receive compensation for medical services. If you print our online form, you must print it in color so that our optical character scanner can "read" the form.

Dental Providers

Dental providers may use the Blue Cross and Blue Shield of Montana (BCBSMT) Dental Claim Form to receive compensation for services.

If the services are provided in Montana submit claims to:

Blue Cross Blue Shield of Montana
PO Box 660247
Dallas, TX 75266-0247

View all our Provider Forms.

More claims filing information is published in the BCBSMT Provider Manual.

Related Resources

Documentation and Coding Resources