Provider Connection

Department of Labor & Industery (DLI) Fee Schedule Update 2020

The Montana Department of Labor & Industry (DLI) has published the new Proposed amendments to the Professional and Facility fee schedules.  Hearing information can be found on the DLI website at http://dli.mt.gov/events/calendar.asp.  Highlights of changes are:

Base Rates for Facility:

Inpatient Hospital $8,909.00
Ambulatory Surgery Center $       92.00
Outpatient Hospital $     123.00

Conversion Rates for Professional Services:

Standard $63.41
Anesthesia $67.32

99080 – This code will be used to bill when a provider is responding to the Drug Formulary letters.

See http://erd.dli.mt.gov/work-comp-claims/medical-regulations/montana-facility-fee-schedule-agreement​ for the July 2020 Instruction Set for the Facility Fee Schedule and https://mtwc.optum.com/ for the July 2020 Instruction Set for Professional Fee Schedule.  For any questions, contact Celeste Ackerman at 406-444-6604.

 

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Bill Status – 1-866-274-7464

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

RMS (Bill Status)
Phone  866-274-7464
Email customer.care@risingms.com

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


Medical Team

Michele Fairclough
Medical Team Leader
406-495-5362

Justin Kennedy
Nurse Manager
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

Sheryl Semans
Pharmacy Liaison
406-495-5010

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)