Changes on the Horizon for Medical Bill Processing and Payment
For the past several years, Montana State Fund (MSF) has contracted with CorVel Corporation to review medical bills for payment on our behalf. State law requires MSF to periodically go through a competitive bid process for these types of services. MSF completed the process in May of this year and the new contract has been awarded to ACS.
Although ACS is also handling the state’s Medicaid bill processing, there are significant differences between that work and their work for MSF – including, a completely different staff to handle the MSF bills.
ACS will begin processing MSF’s medical bills based on the WC Administrative Rules, the DLI fee schedules and MSF business rules effective January 1, 2011. There are no changes to those as a result of our moving from CorVel to ACS.
We are working with both CorVel and ACS to facilitate a smooth transition to minimize the impact for providers with this change.
To assure a smooth transition from CorVel to ACS, we will stop sending new bills to CorVel effective December 12. CorVel will process anything provided to MSF prior to that date, as well as re-evaluations, refunds and underpayments, through the end of the year. Payments to providers will continue from CorVel into the new year, but for bills from December 12 and prior.
To clear the transactions between CorVel and MSF, bills that arrive after December 12 will be held for ACS processing. MSF will not be able to make payments on those bills until January, and those payments will come through ACS.
We will pay all the bills appropriate for payment, at the appropriate levels, but December payments for bills that arrive at MSF after December 12, will take longer than usual. Our goal is to minimize the delay, but we cannot eliminate it. Denials of bills, not appropriate for payment will see the same delay.
Bills that arrive at MSF on December 13 or later, will see a delay in approval, payment or denial until January as a result of this transition. We expect to be caught up and back to normal processing times by the end of January.
For questions regarding the transition contact Bridget McGregor at 406-495-5277.
For bill or payment questions through 12/30/11 please contact CorVel at 1-866-868-3828 or 406-442-6977, or a member of the Medical Team at 406-495-5011. Please remember, CorVel will not have any information regarding bills or reconsideration requests that arrive at MSF after December 12.
For bill status questions for bills that arrive at MSF after December 12, and for all transactions after January 1, 2012 contact ACS at 1-877-591-8028 or a member of the Medical Team at 406-495-5011.