Provider Connection

Transition Marked by Fast Turnaround Times and More.

Hints for taking advantage of the new improvements.

Here at Montana State Fund, one way to describe the many services we offer providers may be “in transition.“ Certainly, “improving” describes them as well. As always, we appreciate your patience, understanding and feedback while we make our services the best they can be.

The Transition to CorVel. Last year, MSF contracted with CorVel Corporation to improve the medical bill payment processing function. The transition began in March 2006, and while we have experienced a few minor issues, the process is running smoothly. Improvements you’ll be noticing include faster turnaround times, Explanation of Review (EOR) with payment, one payment-per-injured-worker and an end to automatic overpayment recovery from other claims.

CorVel continues to process provider medical bills for services to our injured workers in accordance with the Administrative Rules of Montana set by the Department of Labor and Industry and MSF’s business rules and policies.

One of the services CorVel brings to MSF is Advanced Nurse Review. Current Procedural Terminology (CPT) guidelines, Correct Coding Initiative (CCI) and American Academy of Orthopedic Surgeons (AAOS) edits are standards utilized for review of bills with multiple procedures and/or services in addition to the audit of inpatient/outpatient hospital based care. A review may also be requested by a claims examiner. CorVel offers expertise and experience in utilization and review of medical services, and must conduct the review pursuant to Administrative Rules of Montana 24.29.1526, which stipulates that only reasonable and necessary medical expenses related to the compensable injury are payable.

Completing Forms Accurately. CorVel will return unprocessed documents to MSF if they are missing critical information. This chart will help you avoid a return when billing on a CMS-1500 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)