It is our job as a workers’ compensation insurer to ensure that injured employees receive appropriate medical care for optimum results. But as we are all well aware, the cost of providing this care has skyrocketed. Montana State Fund has been grappling with this issue and has taken steps over the past few years to improve how we manage claims and contain these medical costs. We are improving our efficiencies with increased training and education for our claims examiners and we hired more medical staff to assist with our claims.

New Medical Hires
In December we hired our first medical director, neurosurgeon Dr. Paul Gorsuch. With his expertise, Dr. Gorsuch will continue to train our claims and medical management staff on appropriate treatment for injuries. Also, he will meet regularly with medical providers to discuss the medical trends we see–with their goal always to promote optimal outcomes for our injured employees.

In addition to the medical director, we created a new provider relations specialist position. Michele Fairclough, a veteran MSF claims examiner with over 22 years experience, took on this role. In this position she directly communicates with providers and their office staffs about the information we need to efficiently handle claims. Her knowledge of workers’ compensation insurance will be invaluable when providers have questions about the new state-mandated medical utilization guidelines providers must adhere to and the finer points of the workers’ comp system.

Overall, we are confident that our improvements in claim management and provider communication will translate into lower overall costs for our policyholders and guarantee that our injured employees have timely access to appropriate medical care provided by medical professionals most competent to address their particular injuries.

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