Provider Connection

Provider Resources On Our Website

HandMouse_72737808Our medical team wants to make it easy for you to work with us. With that in mind, we have created useful tools and forms that you can access on our website. Simply go the website, click on I am a Medical Provider, then Provider Resources.

Below are a few of the resources.

Injection Log
We have devleoped a downloadable injection log to be used when an injured worker is undergoing diagnostic injections recommended by the Montana Utilization and Treatment Guidelines. The Guidelines specify that “at a minimum, . . . a log must be recorded as part of the medical records which documents response, if any, on an hourly basis for, at a minimum, the expected duration of the local anesthetic phase of the procedure.”

Opioid Risk Assessment, Functional and Pain Monitoring, and Pain Contracts
To help you manage chronic pain for injured workers you will find links to national opioid risk assessment tools, functional and pain monitoring tools, and sample narcotic agreements and contracts.

Physical Therapy Precert Request Form
To assist us in evaluating ongoing physical therapy requests for functional improvement we ask providers to complete our Physical Therapy Precert Request Form.

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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

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

Justin Kennedy
Nurse Manager

Shannon Hadley
Provider Relations Specialist

Kym Vonada
Medical Auditor

Annalyn Stewart
Medical Payment Auditor

Sheryl Semans
Pharmacy Liaison

Susan Bomar
Medical Payment Auditor

Cindy Gallus
Medical Customer Service Liaison

Sherri Sprenger
Medical Customer Service Liaison

Shannon Mergenthaler
Medical Customer Service Liaison

Maggie Pentecost
Medical Customer Service Liaison

Jamie Statton
Medical Customer Service Liaison

Website Information

Montana State Fund

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)