Provider Connection

The Provider Connection is an online informative newsletter geared towards our medical providers. We produce the newsletter twice a year. If you are not on the e-mail list sign up to receive it.

19TH ANNUAL MEDICAL CONFERENCE FOLLOW UP

Thank you to all who attended our 19th Annual Medical Conference. Please find the  2019 Medical Conference Program from the two-day event. You can also review all of the speaker presentations on our website. Mark your calendar for next year’s ...

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2019 MTWCC 2; WCC No. 2018-4207 Everett Pate v. Montana State Fund

FINDINGS OF FACT, CONCLUSIONS OF LAW, AND JUDGMENT Summary:  Petitioner asserts that he injured his shoulder in an industrial accident in which a rung on a ladder broke, causing him to fall down and backwards, partially into a crawlspace.  Respondent ...

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Medical Billing

Work Comp EDI Now that we are up and running with Rising Medical Solutions (RMS), electronic billing is an option for those providers who want to switch from paper billing.  To get signed up please call Work Comp EDI at ...

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Medical Bill Coding

Dry Needling – The Code Dilemma Billing for dry needling tends to bring up questions regarding code selection as there isn’t a code that specifically describes this procedure.  Some publications advise using 97140 (manual therapy techniques) or 97112 (neuromuscular re-education) ...

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Workers’ Compensation Drug Formulary

Effective for claims arising on or after April 1, 2019. In May 2017, the Montana Legislature passed SB312, authorizing the Montana Department of Labor & Industry to adopt a drug formulary for the workers’ compensation system. The formulary will work ...

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New Medical Bill & Payment Vendor

Effective January 1, 2019, Rising Medical Solutions (RMS) will be our new bill review and payment vendor. We believe this partnership will make the bill review process timelier and more accurate for our providers and claim examiners. One major enhancement ...

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State Adopts Drug Formulary For Workers’ Compensation System

In May 2017, the Montana Legislature passed SB312, authorizing the Montana Department of Labor & Industry (DOLI) to adopt a drug formulary for the workers’ compensation system. The formulary will work in conjunction with the Montana Utilization & Treatment Guidelines and ...

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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 ...

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Save The Date: Medical Conference 2019

Montana State Fund will hold our 19th annual medical conference May 16 – May 17, 2019 in Helena at the Delta Hotels Colonial. More details about the conference will be coming after the new year. If you have any questions ...

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TROY W. WESTRE v. LIBERTY NORTHWEST INS. CORP.

ORDER DENYING RESPONDENT’S MOTION FOR SUMMARY JUDGMENT AND GRANTING PETITIONER’S MOTION FOR SUMMARY JUDGMENT Summary: Respondent moved for summary judgment, asserting that Petitioner’s medical benefits terminated under the 60-month rule at § 39-71-704(1)(f), MCA (2005). It is undisputed that Petitioner ...

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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)