We are happy to bring you another Montana State Fund Provider Bulletin.

This publication is intended to keep you informed of workers’ compensation issues and medical billing information that affect you. If you have any questions about the bulletin or any of the articles, please call a member of the Medical Team at 406-495-5011.


For the past several years, Montana State Fund (MSF) has contracted with CorVel Corporation to review medical bills for payment on our behalf.  State law requires MSF to periodically go through a competitive bid process for these types of services.  MSF completed the process in May of this year and the new contract has been awarded to ACS.

Although ACS is also handling the state’s Medicaid bill processing, there are significant differences between that work and their work for MSF – including, a completely different staff to handle the MSF bills.    

ACS will begin processing MSF’s medical bills based on the WC Administrative Rules, the DLI fee schedules and MSF business rules effective January 1, 2011.  There are no changes to those as a result of our moving from CorVel to ACS. 

We are working with both CorVel and ACS to facilitate a smooth transition to minimize the impact for providers with this change. 

To assure a smooth transition from CorVel to ACS, we will stop sending new bills to CorVel effective December 12.  CorVel will process anything provided to MSF prior to that date, as well as re-evaluations, refunds and underpayments, through the end of the year.  Payments to providers will continue from CorVel into the new year, but for bills from December 12 and prior. 

To clear the transactions between CorVel and MSF, bills that arrive after December 12 will be held for ACS processing.  MSF will not be able to make payments on those bills until January, and those payments will come through ACS. 

We will pay all the bills appropriate for payment, at the appropriate levels, but December payments for bills that arrive at MSF after December 12, will take longer than usual.  Our goal is to minimize the delay, but we cannot eliminate it.  Denials of bills, not appropriate for payment will see the same delay. 

Bills that arrive at MSF on December 13 or later, will see a delay in approval, payment or denial until January as a result of this transition.  We expect to be caught up and back to normal processing times by the end of January. 

Transition:
For questions regarding the transition contact Bridget McGregor at 406-495-5277.

For bill or payment questions through 12/30/11 please contact CorVel at 1-866-868-3828 or 406-442-6977, or a member of the Medical Team at 406-495-5011.  Please remember, CorVel will not have any information regarding bills or reconsideration requests that arrive at MSF after December 12. 

For bill status questions for bills that arrive at MSF after December 12, and for all transactions after January 1, 2012 contact ACS at 1-877-591-8028 or a member of the Medical Team at 406-495-5011.

 

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Points of Contact

For questions regarding:

  • Information in this bulletin, call 800-332-6102 and ask for a member of the Medical Team.
  • Montana State Fund website www.montanastatefund.com (Go to I am a Medical Provider Section)

CorVel

  • Payment status or questions regarding an EOR prior to December 31, 2011 call 406-442-6977 or 1-866-868-3828

ACS

  • Payment status or questions regarding an EOR after January 1, 2012 call 1-877-591-8028 

DLI

  • Questions regarding DLI Fee Schedule or Utilization and Treatment Guidelines call Maralyn Lytle at 406-444-6604
  • DLI website: http://erd.dli.mt.gov/. 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.
  • Montana Utilization and Treatment Guidelines: .mtguidelines.com

Montana State Fund Medical Team
Bridget McGregor
Medical Team Director ... 406-495-5277

Kym Vonada
Nurse Review..................406-495-5389

Michele Fairclough
Provider Relations Specialist..406-495-5362

Medical Team Auditors ... 406-495-5011

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