Provider Bulletin

Resubmissions/Corrections/Records

CORRECTED BILLS
When submitting a corrected bill (CMS 1500 or UB04), please mark the bill “CORRECTED BILL” to indicate that there has been a change to the original billing. Please include a copy of the EOR and any records to support the charges.

RESUBMISSIONS
If multiple services were billed on a CMS 1500 but not all services were paid, please resubmit the original bill with the additional information or reason that you are requesting reconsideration. Do not bill those lines on a new bill or add them to a new billing.  This will maintain the integrity of the original billing and reduce denials for duplicate charges.  Submit your request with a copy of the EOR and records or information to support the request.

ADDITIONAL RECORDS
When submitting additional records, please attach a copy of the bill, the EOR and the request for reconsideration and mail to:

MONTANA STATE FUND
PO BOX 4759
HELENA, MT  59604

 

Bill Status – 1-877-591-8028

Main Phone Number 406-495-5000 or 800-332-6102

Main Fax  406-495-5020

Medical Team – 406-495-5011

Submit your Claims and/or Correspondence To
Montana State Fund
PO Box 4759
Helena, MT  59604

ACS (Bill Status)
Phone  888-208-2116
Email  BillReviewInquiries

For questions regarding
: Information in this bulletin, call 800-332-6102 and ask for a member of the Medical Team. Advanced Nurse Review, Kym Vonada at 406-495-5389.


Medical Team

Michele Fairclough
Medical Team Leader
406-495-5362

Heather O’Hara
Nurse Manager
406-495-5458

Justin Kennedy
Medical Management Specialist
406-495-5417

Shannon Hadley
Provider Relations Specialist
406-495-5245

Kym Vonada
Medical Auditor
406-495-5389

Annalyn Stewart
Medical Payment Auditor
406-495-5367

Susan Bomar
Medical Payment Auditor
406-495-5271

Cindy Gallus
Medical Customer Service Liaison
406-495-5189

Sherri Sprenger
Medical Customer Service Liaison
406-495-5420

Shannon Mergenthaler
Medical Customer Service Liaison
406-495-5185

Maggie Pentecost
Medical Customer Service Liaison
406-495-5322

Jamie Statton
Medical Customer Service Liaison
406-495-5386

Website Information

Montana State Fund montanastatefund.com

Department of LaborDepartment of Labor and Industry (DLI) website.
The website includes the Facility and Non-Facility Fee Schedule information as well as the Administrative Rules of Montana (ARM) and the instruction set for the Non-Facility Fee Schedule. Historical fee schedule information can also be found on this website.

If you have questions regarding the fee schedules call 406-444-6530 and someone will direct you to a DLI representative. For NPI information click here National Plan and Provider Enumeration System (NPPES)