MEDICAID FORMS
current as of December 2023 | updates coming soon
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Please send any forms that include STUDENT NAMES & INFORMATION via our secure webfile program, ShareFile. ALL forms for the RELAY Medicaid Billing Service Portal program can be viewed and downloaded (see below). Please use the Sharefile link above to send student forms, or fax forms directly to our office at (406) 624-6289. Please DO NOT send student names and information via email! Student Info Sheet
Use this form to add or change student information in the RELAY Service Portal. Make sure to download the form so you can fill it in as a PDF file and send the form using ShareFile. Child Profile Form This form should be filled out for paraprofessional Services and signed by a physician. Services on the form should match what is included in the IEP and should be updated at least annually. Please send a copy of the form using the ShareFile link. Personal Care Services Daily Sheet Daily paraprofessional tasks should be logged daily. This form can be used to help add service times to the RELAY Service Portal and should be kept in a student file for 6 years, 3 months in case of a service audit. RELAY Service Portal Instructions Therapy providers can access these instructions for using the portal. RELAY Service Portal Paraprofessional and Nursing Instructions Paraprofessional aides for personal care services and nurses use this manual for instructions on entering services into the portal. Saving Student Goals in the RELAY Service Portal When a student is initially added to a therapy providers caseload, goals can be uploaded to a student account. Saving groups in the RELAY Service Portal Use these instructions for creating groups in the portal. |
PROGRAM CONTACT
Lisa Waterman
Medicaid Billing Program Manager
E-mail: lwaterman* (see footer)
Office (406) 272-0073 | Fax (406) 624-6289
Lisa Waterman
Medicaid Billing Program Manager
E-mail: lwaterman* (see footer)
Office (406) 272-0073 | Fax (406) 624-6289