Provider Connection

National Provider Identifier (NPI)

The NPI is a required element for all bill types. A provider can obtain the number by contacting the National Plan and Provider Enumeration System (NPPES). When a bill is input in the system for processing, a validation process is used.  If you have been receiving denials due to an NPI issue, the following may be the reason:

  1. Rendering provider NPI missing – this means that the individual NPI for the actual service provider is missing from Box 24J of the CMS 1500 form;
  2. Rendering provider NPI incorrect – The NPI entered in Box 24J of the CMS 1500 form does not match the actual service provider submitted in the documentation. The NPI used must be that of the provider who has provided the service and signed the medical record;
  3. Practice Provider NPI missing or does not match – this NPI is required in Box 32a of the CMS 1500 form and must match or closely match the name that is registered on the NPPES website. Exception is if the Place of Service is 12 (home) in Box 24B;
  4. Billing Provider NPI is missing or does not match – this NPI is required in Box 33a of the CMS 1500 form and must match or closely match the name that is registered on the NPPES website;
  5. Attending Provider NPI missing or does not match – the attending provider NPI in Box 76 of the UB04 form is required for all services. This should be the NPI of the attending provider or the provider responsible for the care of the patient.

Please see the NPPES website for more information.

back to Provider Connection

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

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)