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.

Medical Management Responsibilities of the Treating Physician/PCP Role

The designated treating physician is responsible for the coordination and management of all medical care for the injured employee.  Once the provider is designated  the Primary Care Provider (PCP), she/he will be paid 110% of fee schedule and all other ...

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Rising Medical Solutions/ECHO/Crefuns

It has been nine months since Rising Medical Solutions (RMS) started reviewing and processing bills for Montana State Fund (MSF).  While we are off to a good start, the following are some of the most common calls we are fielding ...

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IME News – Catherine Heffernan vs. Safety National Casualty Corp.

Summary: Claimant appeals an Amended Order Directing Medical Examination, in which the DLI ordered her to attend a panel IME. Claimant argues that the DLI erred because: (1) it declined her request to allow her to make an audio recording ...

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Evaluation and Management – Time

When using time to support a level of service under Evaluation and Management, total time spent face to face with the patient must be documented along with documentation of what was included in the counseling and/or coordination of care.  Simply ...

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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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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)