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    April 26, 2021

    Home Respiratory Services and Durable Medical Equipment (DME) Provider

    Montana State Fund is pleased to announce our new relationship with Rising Medical powered by VGA/Homelink as our exclusive Home Respiratory Services and Durable Medical Equipment (DME) provider. This expanded partnership with Rising Medical will provide to MSF and its employers/insured all DME and Home Respiratory Services. The partnership took effect February 1, 2021.

    For providers who would like to order Home Respiratory Services or DME supplies for MSF claimants/insured, we have available the below options to send your referrals.

    Physician Referrals can be emailed, completed on-line, call or fax us:

    Rising Medical Solutions’ Customer Contact Information for Montana State Fund DME Program

    To Submit a Referral via e-Mail RisingDME@risingms.com

    To Submit a Referral Online Under Ancillary Medical Service – Click Durable Medical Equipment

    https://vision.risingms.com/vision/referral/referralrequest

    To Submit a Referral via Fax 312- 224- 1302

    Rising Medical powered by Homelink offers 24/7 customer service, clinical advice and equipment troubleshooting if you have any questions about your home respiratory or DME. A team of highly trained professionals will help coordinate the delivery, setup, proper usage, maintenance and ongoing support of your DME and supplies.

    For DME Dispensed from a provider office

    24.29.1523    MEDICAL EQUIPMENT AND SUPPLIES FOR DATES OF SERVICE ON OR AFTER JULY 1, 2013

    (1) For both facility and professional services, reimbursement for DME dispensed through a medical provider is determined by the professional fee schedule in effect on the date of service, except for prescription medicines as provided by ARM 24.29.1529. On March 31 of each year, or as soon thereafter as is reasonably feasible, the professional fee schedule with updated HCPCS will be posted on the web site. If a RVU is not listed or if the RVU is listed as null, reimbursement is limited to a total amount that is determined by adding the cost of the item plus the lesser of either $30.00 or 30 percent of the cost of the item plus the freight cost. An invoice documenting the cost of the equipment or supply must be sent to the insurer upon the insurer’s request.

    (a) Copies of the instructions are available on the department web site or may be obtained at no charge from the Montana Department of Labor and Industry, P.O. Box 8011, Helena, Montana 59604-8011.

    (2) If a provider adds value to DME (such as by complex assembly, modification, or special fabrication), then the provider may charge a reasonable fee for those services. Merely unpacking an item is not a “value-added” service. While extensive fitting of devices may be billed for, simple fitting (such as adjusting the height of crutches) is not billable.

    If you have questions please contact Montana State Fund Medical Services Director Michele Fairclough at mfairclough@mt.gov or call 406-495-5362.