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    National Provider Identifier (NPI) – Still an Issue 

    What is an NPI?
    The NPI is the National Provider Identifier that is used by Medicare to be able to track where practitioners are providing services.  MSF uses them for similar reasons but these numbers are also required for reporting information to National Council on Compensation Insurance (NCCI).  The NPI Registry is found at NPPES NPI Registry (hhs.gov) which is also where providers can apply for an NPI.  Providers generally receive a number within a day or so.  MSF requires NPI’s for all providers who bill for services for workers compensation.

    Where are NPI’s used?

    • UB04 form:  NPI’s are required in Box 56 (service facility), Box 76 (attending provider and Box’s 77 – 79 (operating and other) if applicable.
    • CMS 1500:  Box 24J (service provider), 32a (service facility location) and 33a (billng provider). 

    The names the NPI’s are registered needs to match the billing form used.

    Please be sure the NPI’s entered are correct and match the NPPES registry.  This will help eliminate denials and having to submit corrected bills for reconsideration.  If you have questions, please contact the Medical Audit Team at 406-495-5011.

    Please No Highlighting

    When you submit reconsideration requests or any other type of information you want us to notice, please do not highlight. Highlighted materials do not image. And when scanned, it is blacked out.  

    For best results, only use a black or blue pen (red pen disappears in a scan) and emphasize with the following:

    • Circle the information
    • Draw a star ** or an arrow à next to the information
    • Underline the information

    Timely Filing

    We are approaching the anniversary of the timely filing rule that took effect July 1, 2022.  The Montana Department of Labor and Industry (DLI) added the Administrative Rules of Montana (ARM) rule 24.29.1402(1)(c) which in part states:

    (c)A provider of medical treatment or services shall only be paid for services under this chapter if the bill for medical treatment or services is timely received by the employer or appropriate payer.  Absent a showing of good cause, a bill for treatment or services is timely received by the employer or appropriate payer when it is actually received within 365 days of the later of:

    • The date of service; or
    • The date the provider of medical treatment or services knew the treatment or services was related to a claim for benefits under this chapter.

    The rule can be found at https://rules.mt.gov/gateway/ruleno.asp?RN=24%2E29%2E1402.  If you have questions about this rule, contact Celeste Ackerman, Administrative Officer (DLI) at 406-444-6604.

    Reconsideration Requests

    When you submit a reconsideration request, please attach a copy of the EOR with the request.  This readily identifies it as a reconsideration request and does not get processed as a duplicate.

    When you submit a corrected bill, please mark the billing form as a correction. The original billing should remain the same, with the exception of the line/code that has been corrected.  If you only submit a corrected code, or a code that was previously denied on a multiple line billing, it could appear as a replacement bill or as unbundling etc.  It also makes it easier to process the request.

    To prevent denials due to the timely file rule, request a reconsideration as soon as possible.  This ensures providers have revenue coming in and helps MSF keep claim costs current. 

    Requests can be sent via mail to:
    Montana State Fund
    PO Box 4759
    Helena, MT  59604

    Or faxed to:
    406-495-5020.

    Durable Medical Equipment (DME) Requests

    DME requests that are outside of what a provider clinic dispenses can be sent directly to RMS at RisingDME@risingms.com.  RMS will take care of getting authorization from MSF and in obtaining the DME items as well as negotiating the fees.  They can also be contacted by phone at 1-888-959-0043.

    Items that are dispensed and billed for under the provider clinic do not need to go to RisingDME.  DME is processed under the Department of Labor and Industry (DLI) Administrative Rules of Montana 24.29.1523

    (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.

    MICHAEL RAY Petitioner vs. OHIO SECURITY INSURANCE CO

    Summary: Petitioner alleges that his industrial accident caused a left shoulder injury and a permanent aggravation to his preexisting cervical spine condition.

    Held: Respondent is not liable for Petitioner’s left shoulder injury nor his cervical spine condition because Petitioner failed to meet his burden of proving that his industrial accident caused his left shoulder injury nor that his industrial accident caused an aggravation to his cervical spine condition. Because neither Petitioner nor his wife was a credible witness, this Court was not convinced that Petitioner’s symptoms started with his industrial accident. In turn, because the physicians on whom Petitioner relied for his medical causation opinions based their opinions on Petitioner’s history, this Court did not give their opinions any weight. Moreover, the physician on whom Petitioner relied for his medical causation opinion regarding his cervical spine condition opined that the industrial accident did not aggravate his preexisting cervical spine condition.

    Read more.

    It’s Your Policy – Access It Your Way: New Policyholder Portal

    Customer Connect is Montana State Fund’s new policyholder portal. The recently launched portal makes it easy for you to access and manage your policy information in a new way.

    Customer Connect Allows You To

    • Review policy details, coverages, & billing information
    • Report payroll
    • Make premium payments
    • Access policy documents
    • Request changes and make updates to your policy
    • Enjoy more online reporting options, including construction credit application

    If you have questions about Customer Connect, or are interested in getting your access, please contact one of our customer service specialists at stfpolicy@msf.gov or (406) 495-5000.

    Safety Know How: March Safety Workshops

    Montana State Fund’s Safety Services Specialist Kirk Smith will hit the road this March to present his free safety workshop Safety Know How.

    Register Now

    Topics include:
    Building a Strong Safety Culture (Part I)
    In this three-part safety workshop series, we will systematically break down the key concepts and approaches your organization must support to build a strong safety culture.  This will be a deep dive into how you can create and implement safety programs and policies and how your management and front-line workers can align for success.  (Part II will be offered in June 2023 and Part III in September 2023)

    Know Your Personal Protective Equipment (PPE):  It might seem easy to fit the right PPE with the job, but really, your business may not be using the correct PPE for your workers’ safety. In this session, we will examine the distinct types of PPE, the OSHA standard associated with each of them and review PPE best practices.  

    The free trainings are open to all Montanans. You do not need to be a Montana State Fund policyholder to attend.
    Trainings run 8:30 am – Noon. 

    Training Dates and Locations
    Glasgow: Wednesday, March 8 – Cottonwood Inn
    Miles City: Thursday, March 9 – Sleep Inn & Suites
    Billings: Friday, March 10-Hampton Inn West 1-90
    Bozeman: Wednesday, March 15 -Best Western GranTree Inn
    Helena: Thursday, March 16-Best Western Great Northern Hotel
    Great Falls: Friday, March 17-Holiday Inn Convention Center
    Butte: Tuesday, March 21- La Quinta Inn
    Kalispell: Thursday, March 23- Hampton Inn
    Missoula: Friday, March 24-Best Western Grant Creek Inn


    Interested?   Register Now. If you have questions, call 800-332-6102 extension 5361 (Kirk Smith).

    Communication is Key: Injured Employee Survey

    Three of Montana State Fund’s guiding values, do what’s right, deliver with heart and focus on what matters, are at the core of who we are when communicating with our customers. This is especially true when our claims examiners interact with injured employees. To ensure we are honoring our values, we began an annual injured employee satisfaction survey in 2020.  We are happy to report that our level of service has continued to improve throughout this period.

    2022 Survey Take Always

    • Service: When injured employees were asked about the quality of their overall experience with MSF, 81% of survey respondents rated their experience as “Excellent” or “Good”.  This number has increased, with an 80% rating in 2021 and 77% in 2020.
    • Employee Outreach:  Our claims examiners are the lifeline for our injured employees. When asked if our staff-initiated contact about changes with their claim, 81% of respondents “Strongly Agree” or “Agree” that contact was initiated.  This number is slightly up from 2021 with an 80% rating: and significantly up from 2020 with 74%.
    • Timely Benefits: Injured employees are promised timely benefits. When asked if they received their benefits promptly, 89% of respondents indicated “Yes” they received their benefits on time. This again is up from 2021 and 2020 at 84% and 87%.

    It is exciting so many injured employees feel valued, cared for, and informed.  These results continue to trend in the right direction, and there is still room to grow. Our goal is to deliver an exceptional customer experience with every interaction.  Each touch point is critical to delivering on our mission – to partner with employers and their employees to care for those injured on the job and champion a culture of workplace safety for our fellow Montanans.

    Be A WorkSafe Champion

    Montana State Fund is looking for Montana business owners who want to build a strong safety culture at their workplace. Through our free WorkSafe Champions program, Montana employers and their employees are given a solid foundation of knowledge to develop and implement a workplace safety culture.

    Classes will meet in person in March, June, and September from 1pm – 5pm. (See location and dates below). These classes coincide with our statewide quarterly safety workshops in Billings, Bozeman, Butte, Glasgow, Great Falls, Helena, Kalispell, Miles City and Missoula.

    You do not need to be a Montana State Fund policyholder to take part.


    WorkSafe Champions Curriculum
    Six Modules will be covered (two each class)

    Modules
    -Workers’ Compensation 101
    -Claims management
    -Stay-at-Work/Return-to-Work
    -Organization and individual motivation
    -Montana Safety Culture Act
    -Culture
    -Incident management
    -Hazard management and training

    Attendees will be required to identify areas that need improvement within their organizations, create a safety action plan and act on the plan.

    If you or your employees would like to attend, or you have questions, contact Kirk Smith at 800-332-6102 extension 5361 or email kirksmith@safemt.gov .


    Dates and Locations

    March Dates – 1pm-5pm
    Glasgow: Wednesday, March 8 – Cottonwood Inn & Suites
    Miles City: Thursday, March 9 – Sleep Inn & Suites
    Billings: Friday, March 10 – Hampton Inn, West I-90
    Bozeman: Wednesday, March 15 – Best Western GranTree
    Helena: Thursday, March 16 – Best Western Great Northern
    Great Falls: Friday, March 17 – Holiday Inn Convention Center
    Butte: Tuesday, March 21 – La Quinta Inn
    Kalispell: Thursday, March 23 – Hampton Inn
    Missoula: Friday, March 24 – Best Western Grant Creek Inn


    June Dates – 1pm-5pm
    Glasgow: Wednesday, June 7 – Cottonwood Inn & Suites
    Miles City: Thursday June 8 – Sleep Inn & Suites
    Billings: Friday, June 9 – Hampton Inn, West I-90
    Bozeman: Wednesday, June 14 – Hilton Garden Inn
    Helena: Thursday, June 1- Holiday Inn Express
    Great Falls: Friday, June 16 – Holiday Inn Convention Center
    Butte: Tuesday, June 20 – La Quinta Inn
    Kalispell: Thursday, June 22 – Hampton Inn
    Missoula: Friday, June 23 – Best Western Grant Creek Inn

    September Dates – 1pm-5pm
    Glasgow
    : Wednesday, September 6 – Cottonwood Inn & Suites
    Miles City: Thursday, September 7 – Sleep Inn & Suites
    Billings: Friday, September 8 – Hampton Inn, West I-90
    Bozeman: Wednesday, September 13 – Hilton Garden Inn
    Helena: Thursday, September 14 – Holiday Inn Express
    Great Falls: Friday, September 15 – Holiday Inn Convention Center
    Butte: Tuesday, September 19- La Quinta Inn
    Kalispell:  Thursday, September 21 Hampton Inn
    Missoula:
     Friday, September 22 – Best Western Grant Creek Inn


    Making the Grade: College Scholarships

    It’s no secret that the cost for higher education is expensive. To alleviate that burden, MSF created the Growing a Safer Montana (GSM) college scholarships in 2018. Students majoring in safety and health/industrial hygiene and the trade and industry fields are eligible to apply. Twenty students were recently awarded the $4,000 scholarship.


    “It will go a long way towards covering my school expenses this year, and I truly appreciate it,” said Trevor Neumann, a student at Montana Tech and one of this year’s recipients. “I look forward to pursuing a career in safety and health and this scholarship will help me achieve this goal.”


    The goal of GSM is to educate young workers like Neumann about the importance of workplace safety. Since the start of the program, 107 students have received a total of $389,500 in scholarship monies.

    Below is a list of the 2023 GSM scholarship recipients.

    Trade and Industry Scholarships
    Adrianna Morgan    Missoula College University of Montana Sustainable Construction Technology
    Andrew EspelandCity College at Montana State University, Billings  Diesel Technology
    Benjamin Skinner     Flathead Valley Community College        Welding Fabrication
    Brett Harrold             Missoula College University of Montana Diesel Technology
    Aiden GrahamHighlands College of Montana TechPrecision Machining
    Cody Lentz           Helena College University of MontanaIndustrial Welding & Metal Fabrication
    Nicolas Mortensen                         City College at Montana State University, Billings  Welding Technology
    Allison Cole                                        Helena College University of MontanaAutomotive Technology
    Jamar West                                    Helena College University of MontanaAviation Maintenance Technology
    James Kinsey                                    Highlands College of Montana TechMetal Fabrication Technology
    Kourage Craig                                   Helena College University of MontanaMetal Fabrication Technology
    Tessi Preston                                    Highlands College of Montana TechMetal Fabrication Technology
    Kevin Hanenburg                            Highlands College of Montana TechCarpentry   
    Parker Mortensen                          Great Falls College Montana State UniversityWelding Technology
    Wyatt Buxbaum                              Dawson Community College                       Welding Technology
    Montana Tech Scholarships
    Brie BirkenbuelMontana Tech University Occupational Safety and Health / Industrial Hygiene
    Sadiq InuwaMontana Tech University Occupational Safety and Health / Industrial Hygiene
    Hannah OggerinoMontana Tech University Occupational Safety and Health / Industrial Hygiene
    McKenna KaelberMontana Tech University Occupational Safety and Health / Industrial Hygiene
    Trevor NeumannMontana Tech University Occupational Safety and Health / Industrial Hygiene

    Another aspect of GSM is the safety equipment award. Middle and high school construction trades and industry classrooms can get up to $850 in personal protection equipment (PPE). The PPE can range from eye protection, hearing protection to gloves, and welding gear.

    Click for more information about GSM.   

    Register for Montana State Fund’s 21st Annual Medical Conference

    Managing Recovery & Return to Work is the theme of Montana State Fund’s 21st annual medical conference. The event will be held at the Lodge at Whitefish Lake, April 26-28, 2023. 

    The Conference Benefits
    Physicians, Physicians Assistants, Nurses, Physical Therapists, Medical Case Managers, Vocational Rehabilitation Consultants, Claims Examiners, Attorneys and Insurance agents.

    Conference Topics

    • Claims: A Medical Perspective
    • Medical Technology in Workers’ Compensation
    • Preventing Delayed Recovery by Addressing Psychosocial Barriers
    • A Comprehensive Approach to Pain Medicine
    • Successes and Challenges with Return to Work
    • Medical Expert Testimony – Imperatives, Principles and Methodologies
    • A Perspective from the Workers’ Compensation Court
    • Tears and Lies My Radiologist Told Me
    • The Story You Don’t Hear About: How Caregivers Changed My Life for the Better

    Register for Conference and Book Hotel Accommodations.

    For questions or more information, contact Shannon Hadley at shadley@mt.gov or call 406-495-5245.

    A Message from Holly O’Dell, President/CEO, Montana State Fund

    This summer we said goodbye as Lanny Hubbard retired after many years of dedicated leadership. I’m honored to take the helm as MSF’s new President and CEO and would like to introduce myself just a bit to you. 

    I’m a nurse, an attorney, and a businesswoman. I’m here because I strongly believe in the impact a healthy Montana State Fund has in promoting safety and financial well-being.

    As a nurse responding to accidents, I developed a passion for working with people, and came to personally understand the impact an injury has on a person’s life, and the life of their family. 

    As an attorney leading legislative strategy at the state fund in Oregon, I saw firsthand how a strong, balanced, workers’ comp system can create a significant positive impact for employers statewide.

    And most recently as I’ve leaned in on the finance/MBA side, I strengthened my belief in the importance of having a stable, well-run, financially secure state fund to make sure insurance is available and affordable for Montanans.

    Since I started in May, my daughter and I have traveled (almost) all around the state. We’ve discovered warm, engaging people; breathtaking scenery; and a shared passion for making sure Montana is an amazing place to live, work, and play for generations to come. It feels like home already. I can’t wait to explore even more. 

    And I have awesome colleagues. Montana State Fund’s employees are mission driven, have a long history of successfully partnering with workers and employers across the state, and are proud to be Montanans serving Montanans. 

    I’m committed to continuing to figure out together what works for Montanans – what works for our business, and what works for our workers.

    Thank you for choosing Montana State Fund as your workers’ comp carrier. I look forward to meeting many of you.  

    Stay safe out there.

    Holly O’Dell

    Register for Montana State Fund’s Medical Conference

    Managing Recovery & Return to Work is the theme of Montana State Fund’s 21st annual medical conference. The event will be held at the Lodge at Whitefish Lake, April 26-28, 2023 in Whitefish, MT.

    The Conference Benefits
    Physicians, Physicians Assistants, Nurses, Physical Therapists, Medical Case Managers, Vocational Rehabilitation Consultants, Claims Examiners, Attorneys and Insurance agents.

    Conference Topics

    • Claims: A Medical Perspective
    • Medical Technology in Workers’ Compensation
    • Preventing Delayed Recovery by Addressing Psychosocial Barriers
    • A Comprehensive Approach to Pain Medicine
    • Successes and Challenges with Return to Work
    • Medical Expert Testimony – Imperatives, Principles and Methodologies
    • A Perspective from the Workers’ Compensation Court
    • Tears and Lies My Radiologist Told Me
    • The Story You Don’t Hear About: How Caregivers Changed My Life for the Better

    Register for Conference and Book Hotel Accommodations.

    For questions or more information, contact Shannon Hadley at shadley@mt.gov or call 406-495-5245.

    Return to Work Programs, Work

    The benefits of a Return to Work (RTW) program are numerous. Medical providers play a key role in the success of returning an injured employee back to work as soon as is medically capable. 

    Studies show that RTW programs help injured employees heal more quickly and completely while reducing depression and alleviate emotional stress.  Most employees look forward to adding to the productivity of their company through transitional duties. They welcome the chance to be back alongside their friends and co-workers as soon as is medically appropriate. 

    In addition, workers’ compensation insurance payments cover just two-thirds of an injured employee’s pay. By returning to work as soon as possible, injured employees receive their normal compensation sooner, minimizing lost wages and time.

    Click for more information about Montana State Fund’s RTW program.

    Montana State Fund Partners with Data Dimensions for Electronic Billing

    Technology services company Data Dimensions, recently merged with MSF’s electronic billing provider  WorkCompEDI®.  Moving forward, Data Dimensions will process our electronic billing.  

    This merger will be seamless for those of you already using electronic billing. https://datadimensions.com/montanastatefund/.  However, if you are not utilizing electronic billing, we encourage you to sign up.  This easy billing method ensures your transactions are received and processed in the most efficient and prompt manner.

    Sign Up
    Contact Data Dimensions at 800-782-2907 or go to info@datadimensions.com. For more information about Data Dimensions visit their website datadimensions.com.

    Hello From New President/CEO

    Happy Fall!

    This summer we said goodbye as Lanny Hubbard retired after many years of dedicated leadership. I’m honored to take the helm as MSF’s new President and CEO and would like to introduce myself just a bit to you. 

    I’m a nurse, an attorney, and a businesswoman. I’m here because I strongly believe in the impact a healthy Montana State Fund has in promoting safety and financial well-being.

    As a nurse responding to accidents, I developed a passion for working with people, and came to personally understand the impact an injury has on a person’s life, and the life of their family. 

    As an attorney leading legislative strategy at the state fund in Oregon, I saw firsthand how a strong, balanced, workers’ comp system can create a significant positive impact for employers statewide.

    And most recently as I’ve leaned in on the finance/MBA side, I strengthened my belief in the importance of having a stable, well-run, financially secure state fund to make sure insurance is available and affordable for Montanans.

    Since I started in May, my daughter and I have traveled (almost) all around the state. We’ve discovered warm, engaging people; breathtaking scenery; and a shared passion for making sure Montana is an amazing place to live, work, and play for generations to come. It feels like home already. I can’t wait to explore even more. 

    And I have awesome colleagues. Montana State Fund’s employees are mission driven, have a long history of successfully partnering with workers and employers across the state, and are proud to be Montanans serving Montanans. 

    I’m committed to continuing to figure out together what works for Montanans – what works for our business, and what works for our workers.

    Thank you for choosing Montana State Fund as your workers’ comp carrier. I look forward to meeting many of you.  

    Stay safe out there.

    Holly O’Dell

    Customer Connect: Lets You Do Business Your Way  

    Customer Connect is Montana State Fund’s new policyholder portal. The recently launched portal makes it easy for you to access and manage your policy information in a new way.

    Customer Connect Allows You To

    • Review policy details, coverages, & billing information
    • Report payroll
    • Make premium payments
    • Access policy documents
    • Request changes and make updates to your policy
    • Enjoy more online reporting options, including construction credit application

    When Can I Access Customer Connect?
    Policies with a renewal date between March 1-September 17, 2022, can access it immediately.

    Policies that renew after September 17, 2022, can access Customer Connect on the effective date of the new policy term.

    Please be on the lookout for a postcard that explains the new service or visit our webpage .  

    If you need further information contact Erika Ayers, Montana State Fund Business Unit Director, at (406) 495-5462.

    New Advertising Campaign Exposes Montanans to Workplace Safety

    While on the job injuries are not funny, our new advertising campaign is.  The Naked Without It statewide campaign rolled out on Labor Day.

    The campaign features our ridiculous (and strategically positioned) anti-hero Gary, who represents an exaggerated metaphor about the importance of workplaces safety.  By comparing the lack of safety at work to being naked at work is clearly an exaggeration, but it’s a purposeful one, designed to grab viewers’ attention and make a point that sticks.

    The goal of the campaign is to create discussion, increase visits to our safety information website, and reduce injuries at work. It’s a point we can’t afford not to make for the sake of Montana workers, employers, and communities.

    The campaign is highlighted through a mix of media. Broadcast TV, streaming services, radio, podcasts, Facebook, Instagram, Snapchat, website ads, billboards, as well as Cat Griz and Frontier Football TV coverage.

    The campaign runs through mid November.

    Growing a Safer Montana Program Makes an Impact

    The American Association of State Compensation Insurance Funds (AASCIF) recognized MSF’s Growing a Safer Montana (GSM) initiative with a 2nd place AASCIF Community Impact Award. This award acknowledges philanthropic initiatives that advance public understanding of societal issues, problems, or concerns.

    GSM was created in 2017 to reinforce the important of workplace safety for Montana’s young workers. There are two-parts to the initiative.  The high school/middle school personal protective equipment (PPE) awards and the college scholarship program.

    The PPE Awards
    The PPE program aids many cash strapped high school/middle school construction trades (welding, carpentry, automotive tech) and industry classrooms with the purchase of PPE for their students. Through the years, $145,000 worth of PPE has benefited 14,000 students.

    College Scholarships
    The college scholarship program is a competitive $4,000 college scholarship for students studying at Montana’s two-year trade & industry colleges and Montana Tech students working towards a four-year safety and occupational health degree. Since the program’s start, 87 students have received the competitive academic scholarships totaling $309,500.

    Click for more information about the GSM program.

    Timely Filing Rule

    A new timely filing rule took effect (for dates of service on or after) 7/1/2022.   The Department of Labor and Industry (DLI) added the rule under the Administrative Rules of Montana (ARM) 24.29.1402(1)(c):

    (c)A provider of medical treatment or services shall only be paid for services under this chapter if the bill for medical treatment or services is timely received by the employer or appropriate payer.  Absent a showing of good cause, a bill for treatment or services is timely received by the employer or appropriate payer when it is actually received within 365 days of the later of:

    • The date of service; or
    • The date the provider of medical treatment or services knew the treatment or services was related to a claim for benefits under this chapter.

    The rule can be found at:  https://rules.mt.gov/gateway/ruleno.asp?RN=24%2E29%2E1402.  For more information contact DLI’s Celeste Ackerman at 406-444-6604.

    Bill Status Questions

    When calling about the status of a bill, first contact Rising Medical Solutions (RMS) at 866-274-7464.  If you need further assistance, you can call MSF’s Medical Auditors at 406-495-5011.  Please give RMS the maximum 30 days processing time before calling about payment status. However, if you do have payment issues, it is best to bring them to our attention in a timely manner. An extensive list of payments can be time consuming to reconcile.

    Durable Medical Equipment Authorizations

    In February 2021, MSF contracted with RisingDME to provide DME for injured workers.  All pre-authorizations for DME that is not dispensed directly by a provider’s office or clinic should go directly to RisingDME@risingms.com or faxed to 312-224-1327.  This includes authorizations for Bone Growth Stimulators, TENS/Muscle Stimulation units and other name brand items.  If you have questions about a pending authorization or need to relay more information, please call 888-959-0043. 

    For DME that is dispensed directly from your clinic, continue to bill it out as usual – it will be paid per the DLI fee schedule rules under ARM 24.29-1523:

    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.

    Maximum Medical Improvement (MMI)

    MMI is a point in the healing process when further material functional improvement is not reasonably expected from primary medical treatment and a permanent work capacity is defined.  Reaching MMI is a critical decision point in the life of a workers’ compensation claim. At this point the insurance company will determine any additional benefit entitlement based on any permanent loss of function and permanent wage loss that occurred as a result of the injury.  Reaching MMI does not necessarily mean that workers’ compensation will not cover further treatment.

    NATIONAL UNION FIRE INS. OF PITTSBURGH Appellant vs. BENJAMIN RAINEY Appellee.

    Summary: An insurer appeals an order from the DLI awarding interim benefits under
    § 39-71-610, MCA. The insurer asserts that the claimant’s treating physician gave him a
    full duty release and contends that it had the right to immediately terminate his TTD
    benefits without complying with § 39-71-609(2)(a)-(d), MCA, which are commonly called
    the “Coles criteria.”

    Held: The DLI correctly awarded interim benefits. As one of the insurer’s adjusters noted,
    the full duty release generated by the treating physician’s office was most likely a mistake
    because it could not be reconciled with the claimant’s other medical records, which
    indicate that his physical restrictions preclude him from returning to his time-of-injury job.
    Moreover, even if the physician intended to release the claimant to work, a general
    release to work in some unknown job is insufficient grounds for an insurer to terminate
    TTD benefits under the first sentence of § 39-71-609(2), MCA. Montana law requires an
    insurer to have a physician approve a job analysis for an actual job that the claimant is
    physically able, and vocationally qualified, to perform. Finally, the insurer did not have
    grounds to terminate the claimant’s TTD benefits under the first clause of the second
    sentence of § 39-71-609(2), MCA, because the Medical Status Form purporting to release
    him to full duty cannot reasonably be construed as the treating physician’s determination
    that he had reached MMI, had fully recovered, and could return to his time-of-injury job.

    Read Entire Case

    Register for the 2022 Medical Conference

    Register now for our 20th Annual Medical Conference. The theme is Harnessing the Future of Workers’ Compensation. It takes place at the Delta Hotel in Helena, May 19-20, 2022.

    This conference is valuable for Physicians, Physicians Assistants, Nurses, Physical Therapists, Medical Case Managers, Vocational Rehabilitation Consultants, Claims Examiners and Attorneys. Continuing education credits are pending approval.

    Agenda Topics:
    • Occupational Injury Causation, Mark Melhorn, MD
    • Reducing Costs and Improving Outcomes, Marcus Nynas, DC
    • The Top Ten Predictions in Workers’ Compensation, Stuart Colburn, AAL
    • Medical Marijuana, Kathy Collins, PharmD
    • IME’s from the Workers’ Compensation Court, Judge David Sandler
    • Claims Advocacy, Denise Zoe- Algire, MBA
    • When Change Chooses You, Dale Hull, MD
    • An Overview of Traumatic Brain Injury, Tutankhamen Pappoe, MD

    Continuing education credits are pending approval. Click for full agenda and hotel information.

    For questions or more information, contact Shannon Hadley or call 406-495-5245.

    New Evaluation and Management Documentation Struggles

    We’re in a full year now on the new documentation guidelines for Evaluation and Management Services.  It has been a learning experience and most of us are getting it figured out.  The biggest issue MSF is seeing is due to the changes in the way time is used to determine the level of service.  The changes affect code range 99202 – 99215.

    Total Time spent – (Codes 99202-99205 and 99212-99215):

    When using time as a basis for code selection, use the total time on the date of service only.  Time includes both the face-to-face and non-face-to-face time that is personally spent by the physician and/or other qualified health care professionals on the day of the visit – this includes time in activities that require the physician or other qualified health care professional but not time spent by clinical staff.  Time spent on activities that are separately billable are also not included.  Counseling and coordination of care no longer has to dominate the time spent with a patient when using time for code selection, so the statement “of which more than 50%” is no longer applicable and should not be used. 

    Per AMA, time includes the following:

    • preparing to see the patient (such as review of tests etc)
    • obtaining and/or reviewing separately obtained history
    • performing a medically appropriate examination and/or evaluation
    • counseling and educating the patient/family/caregiver
    • ordering medications, tests, or procedures
    • referring and communicating with other health care professionals (when not separately reported)
    • documenting clinical information in the electronic or other health record
    • independently interpreting results (not separately reported) and communicating results to the patient/ family/caregiver
    • care coordination (not separately reported)

    Time does not include the following:

    • the performance of other services that are reported separately (such as xrays, minor procedures, labs etc)
    • travel
    • teaching that is general and not limited to discussion that is required for the management of a specific patient

    Time Ranges for CPT codes 99202-99215:

    CodeTime (Minutes)CodeTime (Minutes)
    9920215-299921210-19
    9920330-449921320-29
    9920445-599921430-39
    9920560-749921540-54

    Prolonged time codes 99354 – 99359 can no longer be used with the above codes for services on the same day.   Two new codes (99417/G2212) may be used with 99205 and 99215. 

    When using 99417 – providers must spend at least 15 minutes beyond the minimum time listed for 99205/99215 and documentation needs to support services where the time was spent.

    When using G2212 – providers must spend at least 15 minutes beyond the maximum amount of time listed for 99205/99215.  This is the only code that Medicare will accept for prolonged services with 99205/99215. 

    Total Duration of New Patient Office or Other Outpatient Services (use with 99205):

    Code(s) less than 75 minutes Not reported separately 75-89 minutes
    99205 X 1 and 99417 X 1 90-104 minutes
    99205 X 1 and 99417 X 2 105 or more
    99205 X 1 and 99417 X 3 or more for each additional 15 minutes.

    Total Duration of Established Patient Office or Other Outpatient Services (use with 99215)

    Code(s) less than 55 minutes Not reported separately 55-69 minutes
    99215 X 1 and 99417 X 1 70-84 minutes
    99215 X 1 and 99417 X 2 85 or more
    99215 X 1 and 99417 X 3 or more for each additional 15 minutes.

    Medical necessity is still the overarching criteria for the level of service – which includes the decision making process of the care provider in addition to the requirements of the CPT code. 

    Click for a helpful publication put out by the American Medical Association (AMA) and CMS .   Other resources are the CPT Manual and Medicare.

    Highlight with Pen

    Please use a black or blue ink pen and circle or star * any information you would like to draw attention. If a highlighter is used, the information does not scan well and it is often too dark to read what is under it.

    JACOB LORENZEN Petitioner vs. EMPLOYERS PREFERRED INSURANCE COMPANY Respondent/Insurer.

    Summary: Petitioner seeks additional benefits, asserting that his industrial accident permanently aggravated his preexisting conditions, including his chronic pain, cervical spine condition; lumbar spine condition; and right foot condition. Petitioner also asserts that his industrial accident caused a brain injury, resulting in headaches and tinnitus.

    Held: Respondent is not liable for additional benefits. Respondent is liable only for those medical conditions caused or materially aggravated by Petitioner’s industrial accident. In his industrial accident, Petitioner suffered a left-wrist sprain, which has completely resolved; a low-back sprain, which has completely resolved; and a herniated disc at C5-6, which has been surgically repaired and which resulted in no additional physical restrictions. Petitioner did not suffer a permanent aggravation to any of his preexisting conditions. Petitioner’s current need for medical treatment and his alleged current inability to return to his time-of-injury job or otherwise work is a result of his preexisting conditions and a nonindustrial left-ankle injury, conditions and injuries for which Respondent is not liable.

    View the entire case

    MSF Scholarships Build a Safety Future

    Growing up in Nigeria, Sadiq Inuwa witnessed first-hand the absence of workplace safety in his country.

    “It is normal to see workers using bamboo sticks as their scaffold and ladders made out of wood. I have seen workers get covered in cement all day long without thinking about potential cement burns. The government does not have agencies dedicated to workers safety and this makes all sorts of violations slide.”

    And in our country, as an intern at an oil company in Colorado he heard about an oil rig worker who lost his finger.  These events piqued his curiosity to enter the safety field.  Today, Sadiq attends Montana Tech, majoring in Occupational Safety & Health.  This passion for safety is paying off.

    Growing Montana’s Safety Future
    Sadiq is one of 20 college students who were recently awarded a $4,000 academic scholarship through Montana State Fund’s Growing a Safer Montana initiative.

    The initiative was created in 2018 to educate young workers about the importance of workplace safety before they enter the workforce. One aspect of the initiative is to supply safety gear for Montana high school trade classrooms.

    The other, is the scholarship program for students like Sadiq who are majoring in the safety and trade fields. Since the program’s inception, 87 students have received the competitive academic scholarships totaling $309,500.

    Adrianna Morgan is another scholarship recipient. She is a Sustainable Construction Technology major at the University of Montana Missoula College. Her goal after her 2023 graduation is to use her creativity to design and build affordable and sustainable living spaces for people in the Missoula.  This includes small vacation rentals that lower income families can access.  

    “I want to build homes that have the future in mind, and that allow people to enjoy life’s pleasures. I want to be at the forefront of all the changes that are going to be taking place soon, as far as sustainability goes. I know I have a lot to learn, but I think I have some innovative ideas.”

    Sadiq explained that his scholarship makes it possible for him to carry out his dream to one day lead a company’s safety team.

    “I want to learn and experience as much as I can in the safety industry and give that knowledge back to workers in the USA, my homeland Nigeria and the world at large.”

    If Sadiq and Adrianna’s aspirations are examples of what Montana’s future workforce hopes to accomplish, our state is in good hands for growing a healthier, safer Montana.

    View all of the 2022 scholarship recipients.

    Click to learn more about the Growing a Safer Montana Initative.

    Sign Up for Free March Safety Workshops

    Montana State Fund’s Safety Services Specialist Kirk Smith will hit the road this March to present his free safety workshop A Small Price for Safety. (For those who cannot make the in-person workshops, a virtual session will be provided at the end of the month).

    Register Now


    Topics
    Job Safety (Hazard) Analysis (JSA or JHA): No matter how you say it, a JSA/JHA can be a useful tool in your quest to eliminate workplace injury. A thorough JSA breaks down a specific job or job task into steps to identify hazards and how to mitigate them. The JSA improves communication, teaches new employees, reinforces what experienced employees already know, and makes your workplace safer. Join Kirk to learn how you can build a solid job safety analysis.

    Control Your Work Comp Costs: In this session we’ll explore three programs, Post-Offer/Pre-Hire Physicals, the Montana Subsequent Injury Fund, and Stay-at-Work/Return-to-Work that can help your organization limit injuries and have a positive effect on your bottom line. In addition, we’ll give an overview on underwriting and how the use of these tools can affect your premium.


    Training Dates and Locations
    The free workshops are open to any Montana worker. They take place from 8:30 am – Noon.

    Butte: Wednesday, March 2 – La Quinta Inn
    Helena: Thursday, March 3 – Holiday Inn Express
    Great Falls: Friday, March 4 – Holiday Inn
    Glasgow: Wednesday, March 9 – Cottonwood Inn
    Miles City: Thursday, March 10 – Sleep Inn & Suites
    Billings: Friday, March 11 – Hampton Inn West
    Bozeman: Tuesday, March 15 – Best Western GranTree Inn
    Kalispell: Thursday, March 17 – Hampton Inn
    Missoula: Friday, March 18 – Best Western Grant Creek Inn

    Virtual (ZOOM) Training Schedule
    Thursday – March 31
    Job Safety (Hazard) Analysis (JSA or JHA) – 9:30 am – 11:30 am
    Control Your Work Comp Costs – 2:00 pm – 4:00 pm


    Interested? Register Now. If you have questions, call 800-332-6102 extension 5361 or email (Kirk Smith).

    ACE: Supporting Safer, Healthier Communities

    A group home in Glasgow, Montana installs an alarm system for their residents. A summer camp in Helena replaces outdated life jackets for the safety of their campers and instructors.  A Senior Center in Eureka rebuilds its deteriorating front steps. What do these three organizations have in common? They each received a grant through Montana State Fund’s ACE (Assisting Charitable Endeavors) program to finance their projects.

    What is ACE?
    ACE is MSF’s charitable giving program. It provides funds to Montana based non-profit organizations for projects that promote safety implementation and improvements.  Over 290 organizations have received a total of $530,000 in grant monies since the programs start in 2001.  Grants range from $250 –$10,000 and require a dollar-for-dollar match.

    ACE Criteria
    An ACE Grant proposal must fit within the scope of Montana State Fund’s normal business and operations:

    • The project will be used to promote workplace safety, host safety trainings, or assist with the purchase of equipment that enhances safety and community well-being.
    • The project will result in a widespread benefit for a Montana community or the state.
    • The project benefits a representative cross section of small and large communities across Montana.
    • The project will have the potential to result in positive public communication

    To find out more details about the ACE program, to apply for funds or view past recipient projects click here.  

    Here’s a Tip: Work Comp Fraud Can Cost Millions

    Work comp fraud isn’t just someone faking an injury. It also includes medical providers authorizing and billing excessive or uncompleted medical services, or employers falsifying payroll records to lower premiums.

    To identify these crimes, Montana State Fund manages a confidential Fraud Tip Hotline 888-682-7463 (888 MT Crime). Callers can remain anonymous.

    For 25 years these “tips” have allowed our fraud unit to work closely with the Montana Department of Justice to investigate and prosecute fraudulent claims and employer misconduct. This partnership has resulted in millions of dollars in savings for our policyholders.  

    If you suspect any type of fraud call our hotline or visit our website to learn more about the signs of work comp fraud.

    MSF Takes Home 1st Place Award

    MSF is committed to provide safety education for all Montanans, which also includes our employees.

    To honor this commitment, MSF received a first-place communications award for our internal virtual 2020 National Safety Month campaign. The American Association of State Compensation Insurance Funds (AASCIF) recognized it as the best in the Internal Communications Campaign category.

    Upon announcing the win, the host of the of AASCIF awards ceremony said that this category was the most competitive. The AASCIF awards recognize the best in communications for those working in the workers’ compensation field.

    The Purpose of the Medical Status Form

    The  purpose behind the Montana Department of Labor and Industry (DLI) Medical Status Form is to evaluate an injured workers return to the workplace. It is a communication tool between a physician, injured worker, and the employer that outlines the current work abilities of the injured worker and whether they return on a part or full-time basis.

    By law, the treating physician or designee must complete the form after each visit. This practice gives the insurer the information they need to handle the claim properly and pay any benefit entitlement promptly. 

    When the provider fills out the form, it should eliminate requests for the same information from the insurer. However, if the insurer asks the provider to answer the same questions outlined on the sent Medical Status Form, the provider may bill the insurer for their time. In addition, providers may bill insurers who ask for more information not contained in the DLI form. Providers should use code MT001.

    The form and instructions are available on MSF’s webpage  or on DLI’s site. You may also request a duplicate hard copy free of charge from DLI. Contact Celeste Ackerman at 406-444-6543 or celeste.ackerman@mt.gov

    Medical providers also have permission to have the form programmed into their medical records system if the name of the form still is the same and all the data fields are included in the same order as DLI’s form. Insurers and medical providers have requested a universal form that is easily recognized by all stakeholders.

    Drug Formulary Notice Change

    As of April 14, 2021, the Montana Department of Labor and Industry (DLI) Legacy Claim Guidance issued March 30, 2020 due to the COVID-19 crisis, is no longer in effect.

    Background
    On March 30, 2020, DLI issued a guidance requesting all TPAs and insurers delay adherence to the Drug Formulary requirements for Legacy Claims (ARM 24.29.1607) due to COVID-19 crisis and concerns of healthcare capacity.

    Medical providers treating Montana State Fund injured employees may receive this type of letter from us that explains the change.

    If you have questions or concerns about this notice, please contact Montana State Fund’s Provider Relations Specialist Shannon Hadley, 406-495-5245.

    Save the Date: 2022 Medical Conference

    Montana State Fund’s annual medical conference will be held at Helena’s Delta Hotel, May 19 – 20, 2022The theme is Harnessing the Future of Workers’ Compensation. 

    Physicians, Physicians Assistants, Nurses, Physical Therapists, Medical Case Managers, Vocational Rehabilitation Consultants, and Claims Examiners are encouraged to attend. 

    Continuing education credits are pending approval.

    For questions or more information, contact Shannon Hadley or call 406-495-5245.

    LOCKHART V. NEW HAMPSHIRE INS: LIEN ON MEDICAL PROVIDER PAYMENTS

    One of the unusual components of the Montana Workers’ Compensation system is the Lockhart lien that exists against medical benefits to be paid to medical providers.  The basis for Lockhart liens is a decision by the Montana Supreme Court in Lockhart v. New Hampshire Ins. Co., et al, 295 Mont 4677, 984 P.2d 744 (1999).  In that case, the Supreme Court held that an attorney representing an injured worker in a workers’ compensation insurance claim has a lien for any medical benefit that the attorney obtains for the injured worker.  The lien can be in place for all medical benefits on a claim if the attorney was successful in getting the insurer to accept a previously denied claim or the lien can exist for a specific benefit such as a surgery if the attorney gets the insurer to cover the previously denied surgery.  The lien amount will be 20% of the fee schedule amount payable unless the dispute was resolved by the Workers’ Compensation Court or Montana Supreme Court; in which case the attorney lien will be 25% of the fee schedule amount.

    Lockhart Decision

    Growing the Next Generation of Safe Workers

    It’s often said, that to create a culture of safety, you must build it from the ground up. Landon Stubbs is doing just that. As the woods and building trades teacher at Great Falls High School, he’s not only tasked to teach constructions skills, but keep his students safe in the process.  

    One way he keeps his students safe is through Montana State Fund’s (MSF) Growing a Safer Montana Personal Protective Equipment (PPE) Grant program. The program awards middle and high school classrooms up to $850 in PPE like eye protection, hearing protection, gloves, and welding gear.

    The PPE program is part of MSF’s Growing a Safer Montana initiative to improve Montana’s workplace safety culture. The initiative teaches and reinforces positive safety in the classroom before young students enter Montana’s workforce. This is the third year Stubbs has received the grant.

    “For me and the students, it has helped create a new safety culture that has been lacking in our state. There needs to be a change in our culture to not only promote safety but make it a priority,” said Stubbs.

    In addition to Great Falls High School, 36 other high schools and 11 middle school classrooms received safety gear.  At the start of the 2021 school year, MSF partnered with A&M Fire and Safety in Butte to deliver 2,552 pairs of safety glasses and over 1,400 pairs of gloves to the eligible classrooms

    Selected classrooms cab also use a portion of their grant money to order specialized safety equipment such as machine guards, welding curtains or specialized PPE.

    Since the program’s 2017 inception, over $100,000 worth safety gear has benefited 11,000 students.

    However, MSF realizes there is still work to be done. Montana’s injury rate has remained consistent from 2018 to 2019 at 3.9 injuries for every 100 workers. This back to back incident rate is higher than the national average of 2.8 for every 100 workers.

    MSF is hopeful the Growing a Safer Montana initiative will continue to be a catalyst to lower injury rates for our next generation of Montana’s workers.

    2021 High School Grant Recipients

    SchoolClassInstructor
    Arlee High SchoolWelding/Building TradesEric Koetter
    Belfry High SchoolWelding/ Ag MechanicsKasey McClane
    Belgrade High SchoolWelding/ Woods Eric Kinnaman
    Big Sky High SchoolWelding Caleb Olson
    Bozeman High SchoolWoodsRebecca Brown
    Bozeman High SchoolAuto TechCarl Poeschl
    Bozeman High SchoolMetalsRebecca Brown
    Chester-Joplin-InvernessWelding/ Woodworking Joel Steinmetz
    CMR – Great FallsPre-construction/ Residential ElectricalKarl Berg
    Conrad High SchoolBuilding TradesJim Carroll
    Cut BankWelding Brian Hayes
    Darby High SchoolConstruction TradesMichael Meves
    Dawson High SchoolAg Mechanics/ Welding/ Metals Leanne Hoagland
    East Helena High SchoolWelding/ Carpentry/ Small Engines/ CAD Casey Harris
    Gallatin High SchoolMetals/ Woods/ AutoMatthew Bakken
    Glacier High SchoolWoods 1, 2, 3Richard Peters
    Great Falls High SchoolResidential Electricity Everett Pate
    Great Falls High SchoolWoods/ Construction/ Welding/ Automotive/ Electrical/ Drafting Landon Stubbs 
    Hamilton High SchoolConstruction Tech/ Welding FabRuss Fisk
    Havre High SchoolConstruction Tech/ Woodworking 1, 2 Micky Haney
    Havre High SchoolAuto TechTyler Kropf
    Hays Lodgepole SchoolsWelding Susan Werk
    Helena High SchoolWelding Cindy Galbavy
    Hellgate High SchoolBuilding Trades 1, 2, 3 Charles Rinehart 
    Jordan Public Schools Building Trades/ Welding Patrick Garner 
    Paris Gibson Education CenterAuto/ Welding Joe Wilkins
    Powell County High SchoolsCabinetry/ Carpentry Clint Stevenson 
    Rapelje High SchoolWoodworking/ Welding Joseph Schladweiler
    Red Lodge High SchoolWoodworking/ Carpentry James Sigl
    Red Lodge High SchoolWelding/ AutomotiveJustin Elton
    Sentinel High School Welding/ Carpentry/ Automotive PLTWDavid Burtch
    Turner High SchoolVo-AgTony Warren
    Park High SchoolIndustrial TechnologyJamie Isaly
    Superior High SchoolConstruction/ Welding/ Woods Jeff Schultz
    Colstrip High SchoolAg EdKatie Mitchell
    Custer County High SchoolAg EdTodd Lackman
    Colstrip High SchoolAg and industry edTodd Lackman

    2021 Middle School Grant Recipients

    SchoolClassInstructor
    ArleewoodsEric Koetter
    Charlo SchoolsShopStan Atchley
    Chester- Joplin- InvernessShopJoel Steinmetz
    Darby Middles SchoolCAD/ CNCThomas Wood
    East Valley Middle SchoolTech education/ Industrial TechCory Horne 
    Havre Middle SchoolIndustril arts Austin Ouellette
    Manhatten Middle SchoolShopJosh Mostad 
    Plains Middle SchoolTechnology EducationKyle Mitchell
    Poplar Middle SchoolWoodworking Joseph Hammar 
    Turner Schools Vo-AgTony Warren

    Register for December Free Virtual Safety Workshops

    Join Montana State Fund’s Safety Services Specialist Kirk Smith this December as he virtually presents his free safety workshops Set the Record Straight.

    Register Now

    Topics include:

    OSHA Reporting and Recordkeeping Requirements – OSHA requires most businesses to report and/or record work-related injuries and illnesses.  In this section, we will help you understand what requirements apply to your organization. We will review general OSHA requirements, discuss statutory reporting and filing requirements for workers’ compensation, and examine best practices for reporting and recording work-related injuries and illnesses.

    Incident Investigation:  A workplace incident can be defined as a close call, an injury, an illness, fatality, or damage to your facilities/equipment.  In this session, we discuss the value and purpose of a good incident investigation.  How to investigate and identify the root causes of the incident.  And finally, how to use the information from the investigation process to prevent re-occurrence of the incident in the future.


    Virtual (ZOOM) Training Schedule

    Tuesday, December 7, 2021: OSHA Reporting and Recordkeeping Requirements – 9:30 am – 11:30 am
    Tuesday, December 7, 2021:  Incident Investigation – 2:00 pm – 4:00 pm


    Thursday, December 9, 2021:  Incident Investigation – 9:30 am – 11:30 am
    Thursday, December 9, 2021:  OSHA Reporting and Recordkeeping Requirements – 2:00 pm – 4:00 pm


    Wednesday, December 15, 2021:  OSHA Reporting and Recordkeeping Requirements – 9:30 am – 11:30 am
    Wednesday, December 15, 2021:  Incident Investigation – 2:00 pm – 4:00 pm


    Friday, December 17, 2021:  Incident Investigation – 9:30 am – 11:30 pm
    Friday, December 17, 2021: OSHA Reporting and Recordkeeping Requirements – 2:00 pm to 4:00 pm


    Register Now All workshops are open to any Montana worker, but participants must register to receive a secure Zoom confirmation.  If you have questions, call 800-332-6102 extension 5361 or email (Kirk Smith).

    Safety Keeps On Paying Dividends

    Once again, MSF policyholders will share a $40 million dividend.  Nearly 22,000 or 95% of our policyholders will receive a payment. MSF has paid a dividend every year since 1999.

    “As a public board, made up of private citizens, we were eager to do what we could to help small business owners, nonprofits, and other employers during this difficult time,” said Richard Miltenberger, Chairman of the MSF Board of Directors.

    Dividends are a way to reward employers when better-than-expected investment market performance and positive workplace safety results occur.

    “Dividends are the result of our collective commitment to workplace safety and investment performance, said MSF President and CEO, Laurence Hubbard.  “While investment income is not always predictable, one thing we can say for certain is that operating a safe and healthy workplace is good for everyone.”

    While not guaranteed, the $40 million dividend brings the total dividends paid to policyholders for the last twenty-two years to $366 million.

    Dividend payments will be completed by the end of November.

    Montana Building Industry Association Lays the Groundwork for Safety

    Montana ranks as one of the highest in the nation for workplace accidents and fatalities, with the construction and building industries among the most high-risk. However, the Montana Building Industry Association (MBIA) wants to change these statistics.

    Recently, Montana State Fund presented the MBIA with a $464,095 check for their safety efforts. Three hundred thirteen of MBIA’s safety group policyholders will share this retrospective return.

    “It has been a remarkable partnership working hand-in-hand with Montana State Fund to drive down accident frequency and rates among our members. The employers and workers do the hard part by emphasizing safety each day, but we could not be successful without a true team effort,” said Steve Snezek, Executive Director of MBIA.

    MSF President and CEO, Laurence Hubbard commented.  “MBIA’s group safety program has produced very positive results for Montana employers and workers over the last decade. These efforts should be applauded and hopefully lead others to the realization that safety truly does pay.”

    The average check paid to the safety group policyholders is nearly $1,500. The checks ranged from approximately $12 to more than $20,000 depending on policy size, premium paid and losses incurred.

    Save the Date – 2022 Medical Conference

    Montana State Fund’s annual medical conference will be held at Helena’s Delta Hotel, May 19 – 20, 2022The theme is Harnessing the Future of Workers’ Compensation. 

    Physicians, Physicians Assistants, Nurses, Physical Therapists, Medical Case Managers, Vocational Rehabilitation Consultants, and Claims Examiners are encouraged to attend. 

    Continuing education credits are pending approval.

    For questions or more information, contact Shannon Hadley at shadley@safemt.govt  or call 406-495-5245.

    Safety on Demand: New safemt.com

    It was an intense year and a half of planning, reevaluating, editing content, redesigning templates, programming and countless hours of review before Montana State launched their redesigned safety focused website, safemt.com in May. The redesigned site is more streamlined and intuitive than the prior site.

    Site Highlights

    Safety 101 – In this section a visitor can get a crash course on how to set up a safety program.

    Safety Topics
    – This area designates a page to one particular safety topic – each page consists of a video, quicks tips and valuable resources which include downloadable PDF’s, and websites.

    Return to Work – This easy to navigate microsite helps visitors create and implement a Return to Work program.

    Safety Videos – In this section visitors can review 22 safety educational videos, numerous policyholder spotlights or past advertising campaigns.

    Work From Home page – This page addresses work from home safety issues. This includes setting up a safe workspace, videos on ergonomics and slips and falls, and illustrated stretches to help avoid injury.

    The site also has downloadable posters, guides and information on MSF safety initiatives.

    Be the Vehicle for a Culture of Safety: Upcoming Safety Workshops

    Register Now

    Montana State Fund’s Safety Services Specialist Kirk Smith is back on the road this September with his free half-day safety workshop, Be the Vehicle for a Culture of Safety.  (A virtual training will be presented at the end of the month).

    Topics include:
    Identify On-the Job Hazards
    : Identifying hazards in your workplace is one of the first steps to build a strong safety culture. But before you begin, you need to ask yourself the who, what and how of identifying and reducing hazards at your business.  In this section, we’ll answer the who, what and how, explore hazard identification best practices, and explain how a good hazard reporting program enhances this process.

    Vehicle Safety Programs:  You might not have a designated “fleet” of vehicles for your employees to drive, but if they use their own vehicles for business purposes, it can create a risk for your organization. This type of vehicle use is referred to as a “hidden fleet.”  In this session, we will address the best safety practices for “hidden fleets” and traditional fleet vehicle programs.

    Dates and Locations
    The free trainings take place from 8:30 am – Noon. Workshops are open to anyone. You do not have to be a Montana State Fund policyholder.

    September 8:  Butte – La Quinta Inn
    September 9:  Helena – Holiday Inn Express
    September 10:  Great Falls – Holiday Inn
    September 15:  Glasgow – Cottonwood Inn
    September 16:  Miles City – Sleep Inn & Suites
    September 17:  Billings – Hampton Inn (West)
    September 21:  Bozeman – Best Western GranTree Inn
    September 23:  Kalispell – Hampton Inn
    September 24:  Missoula – Best Western Grant Creek Inn

    Virtual Training
    September 29: Hazard Identification – 9:30 am to 11:30 am.
    September 29: Vehicle Operator – 2:00 pm to 4:00 pm.

    Interested? Register Now. If you have questions, email Kirk Smith or call 406-495-5361.

    Dividends Pay Again

    Over 22,000 Montana State Fund policyholders received a dividend check in May. This group shared a $20 million dividend declared by the MSF Board of Directors at their March, 2021 meeting.

    President and CEO Laurence Hubbard explained that last fall, amid economic uncertainty surrounding the coronavirus pandemic, the Board of Directors opted to take a conservative approach when they declared a $20 million dividend for policyholders in September 2020.

    “At the same time, they pledged to revisit their decision in the spring of 2021 to consider an additional dividend. I am happy they fulfilled that commitment and declared another $20 million. It is our hope that these funds will help Montana employers continue to weather the storm of COVID-19.”

     

    A Champion for Safety: WorkSafe Champion program

    The WorkSafe Champions program gives participants a strong foundation to develop and implement a workplace safety culture. The curriculum provides safety information and tools that participants must use to graduate from the course.

    The program’s Central Class of 2022 is set to begin in September, 2021. This course is open to all Montana businesses. You do not have to be a Montana State Fund policyholder to participate. The only prerequisite is a signed agreement that your organization is committed to the program

    The WorkSafe Champions Central Class will be offered in nine locations around the state

    Billings
    Bozeman
    Butte
    Glasgow
    Great Falls
    Helena
    Kalispell
    Miles City
    Missoula

    Why Commit
    • Only one employee from a business needs to participate.
    • It is an opportunity for participants to interact and network with other businesses in their area.
    • The maximum class size for each location is 15 participants. Priority will be given to policyholders.

    Class Schedule
    Class participants will meet five times between September 2021 to September 2022 (once a quarter), this is roughly 20 hours of classroom time covering eight modules. (click to view dates and locations). At each session, approximately one to two modules will be addressed depending on the amount of discussion and participation. A graduation celebration will take place during the final meeting.

    Course Curriculum
    Module 1 – Introduction to Workers’ Compensation
    Module 2 – Claims Management
    Module 3 – Motivating
    Module 4 – Culture
    Module 5 – Hazard Management & Training
    Module 6 – Incident Management
    Module 7 – Regulatory Compliance
    Module 8 – We Are the Champions

    Course Requirements
    MSF can accept one or more participants per business. At least one of the participants needs to influence safety within their organization. If the company already employs a WSC graduate with a safety influence on staff, a participant can be accepted without authority confirmation. Attendance is necessary to graduate, and participants can only miss one course session. In case of inclement weather or other situations, the MSF instructor can offer a make-up opportunity at their discretion and availability.

    To graduate the participants must accomplish the following within 6 to 12 months:

    • Meet the attendance requirements
    • Complete the eight modules
    • Conduct a workplace assessment of their workplace
    • Create a safety action plan
    • Act on the plan and document the progress (Submitted to MSF)

    If you are interested, please contact Kirk Smith

    Safety Works Media Campaign Hits Airwaves

    MSF’s new Safety Works statewide media campaign went live on July 19, 2021. The campaign focuses on making safety a priority for those Montana workers returning to the workplace.

    The media strategy is a mix of traditional and social media. TV, radio, public radio, and print ads combined with connected TV, podcasts, banner ads, Facebook, and Instagram. The TV ad aired during the Olympics and will air during the Montana State and University of Montana football game season. The campaign runs July 19, 2021 – November 28, 2021.

    In addition to the general audience Safety Works campaign, a young worker’s version was created. The media placement for this target audience is all social media.  The campaign airs July 19,2021 – October 24, 2021.

    Both campaigns have a targeted call to action website landing page that consumers can visit for more information.  

    View the TV ad

    Evaluation and Management (E/M) Changes

    As most providers are aware, the rules/guidelines changed effective 1/1/21.  The changes affect code range 99202 – 99215.

    These changes should help reduce the amount of redundant and overwhelming documentation that was required under the old rules for selecting an E/M level of service.  The level of service is now selected by:

    1. The level of medical decision making as defined for each service, or
    2. The total time spent for that date of service.

    Level of Medical Decision Making – (Codes 99202-99215) consist of 3 components:

    1.  Problem:  the number and complexity of problems addressed
    2. Data:  amount and /or complexity of data to be reviewed and analyzed
    3. Risk:  risk of complications and/or morbidity or morality of patient management

    When using MDM for code selection, two of the above three elements must be met.  See your CPT manual for additional information. 

    Total Time spent – (Codes 99202-99205 and 99212-99215):

    When using time as a basis for code selection, use the total time on the date of service only.  Time includes both the face-to-face and non-face-to-face time that is personally spent by the physician and/or other qualified health care professionals on the day of the visit – this includes time in activities that require the physician or other qualified health care professional but not time spent by clinical staff.  Time spent on activities that are separately billable are also not included.  Counseling and coordination of care no longer has to dominate the time spent with a patient when using time for code selection.

    CodeTime (Minutes)CodeTime (Minutes)
    9920215-299921210-19
    9920330-449921320-29
    9920445-599921430-39
    9920560-749921540-54

    Prolonged time codes 99354 – 99359 can no longer be used with the above codes.  New codes 99417/G2212 may be used with 99205 and 99215.  See your CPT code book for additional information.

    Medical necessity is still the overarching criteria for the level of service – which includes the decision making process of the care provider in addition to the requirements of the CPT code. 

    These changes have added some major confusion to the E/M coding process and it will take some time for everyone to get comfortable with it.  There are many resources out there and some great webinars to help alleviate some that. 

    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.

    Telemedicine Continues

    Due to the COVID-19 virus outbreak and in the interest of keeping everyone safe and healthy,  MSF has made a decision to allow for more telephone health care services to keep our injured employees at home, but continuing on their way to recovery. These guidelines will be in effect until further notice.

    Note:  Please use POS 02 in Box 24B of the CMS 1500 form to indicate that the services provided have been via a telephonic/video type method. The GT modifier may also be applied for audio/video telecommunications. For timed codes, please document total time spent in the record.

    99201 – 99215 Evaluation and Management visits that normally require face to face time will be allowed as audio/video visits. Documentation does need to support the services billed.

    Psychotherapy services

    90832:  30 minutes 90834:  45 minutes 90837:  60 minutes

    Psychological Evaluations will need to be authorized prior to service by calling Michele Fairclough at the number listed at the end of this publication.

    Online Digital Evaluation and Management service, for an established patient, for up to 7 days, cumulative:

    99421:  5-10 minutes 99422:  11-20 minutes 99423:  21 or more minutes

    Telephone Evaluation and Management (E/M) services by a physician or other qualified health care professional who may report E/M services provided to an established patient:

    99441:  5-10 minutes 99442:  11-20 minutes 99443:  21-30 minutes

    Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient or episode of care initiated by an established patient:

    98966:  5-10 minutes 98967:  11-20 minutes 98968:  21-30 minutes

    Qualified non-physician health care professional online digital (non-face to face) E/M service utilizing internet resources for an established patient, for up to 7 days, cumulative time during those 7 days:

    98970:  5-10 minutes98971:  11-20 minutes 98972:  21 or more minutes

    Physical/Occupational Therapy can use the above codes as applicable; also, MSF will allow the following re-evaluation codes:

    97164 – Physical Therapy Re-evaluation 97168 – Occupational Therapy Re-evaluation

    The following Physical or Occupational Therapy initial evaluations will need to be pre-authorized by calling Michele Fairclough at the number listed at the end of this publication:

    97161 97162 97163 97165 97165 97167

    For physical/occupational therapies, MSF will allow the following codes for a total of 2 units (30 minutes) for the management of home exercise:

    97110 97530 97535

    We understand that there may be questions regarding different circumstances as we go along.  Please call Michele Fairclough, Director of Medical Services, at 406-495-5362 or Kym Vonada at 406-495-5389 and we will work toward getting these issues resolved.

    Electronic Billing Partnership

    Montana State Fund and WorkCompEDI have teamed up to maximize electronic submissions for Montana State Fund clients. We have invested a great deal of resources to maximize the value of the partnership.  Montana State Fund bills sent through WorkCompEDI ensure your transactions are received and processed in the most efficient and timely manner.

    To sign up, or schedule a web presentation, please call Work Comp EDI at 800-297-6909 or email mt@wcedisupport.com. https://www.workcompedi.com/montanastatefund.

    Working for Montana

    Montana State Fund launched a new website, workingformontana.com.  It was created to keep stakeholders up-to-date and educated on the history of MSF and the role we play in the state’s workers’ compensation insurance arena.

    Ethan Heverly, Montana State Fund’s Director of Government and Community Relations said, “MSF believes that the key to effective advocacy is education and relationships. This tool is designed to improve our educational efforts to better tell the story of MSF.”

    The site features videos, statistics, podcasts, frequently asked questions, and a section to view current legislative bills associated with workers’ compensation.

    Cause for Celebration – SafetyFestMT

    California celebrates a garlic festival. Colorado hosts a blue grass festival. And in Montana, safety festivals are organized across the state through the Montana Department of Labor and Industries (DOLI) SafetyFestMT.

    SafetyFestMT was created in 2010 to address Montana’s high rates of workplace injuries. The program began as a free, weeklong conference filled with workshops and classes for Montana’s employers and employees to improve on-the- job safety. The conference was made possible through a public/private partnership between DOLI and Montana businesses.  Montana State Fund is one of the founding members.

    “SafetyFestMT’s success is due in large part to our partnership with Montana State Fund and other entities that believe that safety is more than a priority, it’s a core value,” said Casey Kyler-West, SafetyFestMT Coordinator. “Without the buy-in from our partners, we would not be able to offer the number of training opportunities we do, or the wide variety of topics at no cost to our attendees, who might not otherwise have access to this type of training.”

    Initially, SafetyFestMT was held once or twice a year in Billings or Missoula. But attendance has steadily grown, and it is now held four times a year in various cities across the state; in Missoula, Helena, Billings, Kalispell, Miles City, Havre, Butte, Sidney, Lincoln, Lewistown, and Great Falls. From 2010-2020, there have been 13,367 attendees and 1,627 classes offered. Montana State Fund safety professionals have shared their expertise at these events.

    Kyler-West explained that SafetyFestMT is more than safety training, “it’s an effective workforce development tool.” The attendees who earn certifications can advance in their current career or attain employment that they wouldn’t otherwise have been able to.

    “We’ve also added a variety of topics that don’t deal with the traditional safety training, such as Active Shooter, Mental Health First Aid, Management of Aggressive Behavior, as well as topics that are pertinent to current events such as the COVID-19 Pandemic,” said Kyler-West.

    And speaking of COVID-19, SafetyfestMT organizers didn’t let the virus stop them. The group quickly pivoted to host three virtual conferences in 2020, with a fourth virtual event coming March 29- April 2, 2021, from Kalispell.   To register or learn more about the program, go to the SafetyfestMT website.

    Safety 911 – March Safety Workshops

    Throughout March, Montana State Fund safety services specialist Kirk Smith will present our free virtual safety workshop Safety 911.

    Register Now

    How will the workshops be run?
    The Zoom workshops will include two topics. One topic presented in the morning and the second topic in the afternoon. Each session will be scheduled for two hours with a break.  This breakdown gives participants time to step away from their computer to avoid any ergonomic or eye strain issues.

    Topics
    Prepare for Emergencies: Create Emergency Action Plans (EAP) – Emergency Action Plans are proactive risk assessment tools for an organization. Thoroughly crafted and planned EAPs lead to appropriate employee responses in crisis situations.  In this section, we will discuss how to effectively develop emergency action plans and how to include fire extinguisher requirements in them.

    Ergonomics: The Right Fit for Your Employees:  Successful employee ergonomic programs can be a challenge even in the best of times.  Now, throw in Covid-19, with employees working from home, and it becomes even more of a challenge. In this workshop we will offer strategies and tools to help participants assess and implement workable healthy ergonomic solutions for both the home workforce and industrial settings.

    Workshop Dates and Times

    Wednesday – March 10, 2021
    9:30 am – 11:30 am   Emergency Action Plans
    2:00 pm – 4:00 pm   Ergonomics

    Friday – March 19, 2020
    9:30 am – 11:30 am    Ergonomics
    2:00 pm – 4:00 pm   Emergency Action Plans

    Wednesday – March 24, 2021
    9:30 am – 11:30 am   Emergency Action Plans

    Thursday – March 25, 2021
    2:00 pm – 4:00 pm     Ergonomics

     Interested?   Register Now.   All workshops are open to any Montana worker, but participants must register to receive a secure Zoom confirmation.  If you have questions, call 800-332-6102 extension 5361 (Kirk Smith).

    A Lesson in Safety: MSF Academic Scholarships

    Young workers are more likely than their older counterparts to be injured on the job.  Studies indicate that workers under the age of 25 are twice as likely to be injured than workers over the age of 25.  According to the Occupational Safety and Health Administration, about 70 teens die from workplace injuries every year in the United States. Another 70,000 get hurt badly enough that they go to a hospital emergency room.

    We want every young Montana worker to work safely all day and then go home to his or her family. That is why, since 2018, Montana State Fund (MSF) has educated young workers about the importance of workplace safety before they enter the workforce.

    Through our Growing a Safer Montana initiative, MSF awards academic scholarships to college students majoring in Occupational Safety and Health/Industrial Hygiene and the Construction Trade and Industry fields. At our recent virtual scholarship awards ceremony, MSF President/CEO Laurence Hubbard presented 15 Montana students with $4,000 scholarships.

    “We applaud these students for taking the first step in improving Montana’s standing in the nation and look forward to working with them and their employers as an indispensable partner in achieving a safer, healthier and more prosperous Montana,” said Hubbard.

    Since the start of the program, 52 students have received the competitive academic scholarships totaling $169,500.

    The scholarship application process includes taking an educational quiz after watching a short safety video, writing an essay on the importance of safety specific to the applicants desired industry, and explaining how they plan to champion safety in the future. The application requires two letters of recommendation and a minimum cumulative GPA of 3.0 or higher.

    The 2021 recipients include:

    Student Name                  College/University and Program                  

    Cara O’DonnellMontana Tech- Occupational Safety & Health
    Blake NicholsMontana Tech- Occupational Safety & Health
    Sadiq InuwaMontana Tech- Occupational Safety & Health
    Mary India OrtgiesMontana Tech- Industrial Hygiene
    Layne WillisMontana Tech- Industrial Hygiene
    Dylan MillerCity College at MSU Billings
    Transportation, Welding Tech
    David WickwireFlathead Valley Community College
    Welding Fabrication (AAS)
    David JutziFlathead Valley Community College
    Welding Fabrication (AAS)
    Nikolette HarshbargerFlathead Valley Community College
    Welding Fabrication (AAS)
    Mac HauckHighlands College- Construction Technology & Welding
    Nate BeelerGreat Falls College MSU
    Welding Technology & Fabrication (AAS)
    Amanda ParkerMissoula College U of M
    Sustainable Construction
    Brailynn DeMarsMSU Northern
    Welding Technology
    Shawn LeslieFlathead Valley Community College
    Electrical Technology (AAS)
    Clayton MorrisonMissoula College U of M
    Welding Technology

    The Growing a Safer Montana Program has two avenues for reaching the youth of our state. The first being the Scholarship program for those seeking higher education. The second is the PPE grants for High School students in the trades and industry classrooms.  School educators teaching construction trade and industry courses can apply for grants up to $750 that help purchase needed safety materials, equipment, or protective gear for their students.

    To find out more about Growing a Safer Montana go to the scholarships and grants tab on website montanastatefund.com.

    ACE Grants: Twenty Years of Giving Back and Looking Forward

    The Myrna Loy Center in Helena bought a mobile step ladder and upgraded the backstage electrical system with their ACE grant.

    Montana State Fund’s vision is to be an indispensable partner in achieving a safer, healthier, and more prosperous Montana. One of our programs that reflects this vision is our Assisting Charitable Endeavors (ACE) program. In 2021, we expanded the program to offer the Montana non-profit community more financial support.

    What is ACE?
    ACE is MSF’s charitable giving program that provides matching funds to Montana based non-profit organizations for projects that promote safety implementation and improvements.  The program began in 2001. Since its foundation, 280 organizations have received a total of $488,000 in grant monies.

    Grants range from $250 – $10,000.  In the past, our maximum grant amount was $2,000.  All ACE applications require a dollar-for-dollar match.

    ACE Criteria
    An ACE Grant proposal must fit within the scope of Montana State Fund’s normal business and operations:

    • The project will be used to promote workplace safety, host safety trainings, or assist with the purchase of equipment that enhances safety and community well-being.
    • The project will result in a widespread benefit for a Montana community or the state as a whole.
    • The project benefits a representative cross section of small and large communities across Montana.
    • The project will have the potential to result in positive public communication
    The MonDak Boys and Girls Club in Sidney received a grant for the purchase of new window coverings for the security of their clubhouse areas.

    Click here to review the 2020 successful grant recipients.

    Interested?
    To learn more about the program, review past grantees,  or to apply,  go to our website montanastatefund.com and click on the Scholarships and Grants tab. If you have questions about the program contact Ethan Heverly or call 495-5426.

    Safety Works Wherever You Do

    Many of our customers are working from home. That means computer screens perched on cardboard boxes, kitchen tables as office desks and some coworkers who require help with their homework. This new way of working can add extra stress and undo injuries.

    That is why we have created a library of work-from-home resources and handy tips that can help our customers properly set up their workstations, give them useful stretches to ease neck pain and make them aware of hazards that may surround their work area.

    Now more than ever, it is so important that we find ways to help keep Montana’s workers, working, injury free from home, so when they are off the clock, they can genuinely enjoy being home.

    To access the resources go to safemt.com

    Dividend Declared For 22nd Consecutive Year

    Montana State Fund’s (MSF) Board of Directors declared a $20 million dividend to be paid to policyholders in mid-November. This marks the 22nd consecutive year MSF has declared a dividend bringing the total returned to policyholders to $306 million since 1999 ($165 million since 2015).

    “Montana State Fund is proud to be able declare a dividend for the 22nd consecutive year. While dividends are not guaranteed, we have been able to consistently declare dividends thanks in part to our partnership with employers and workers who are committed to operating a safe and healthy work environment,” said MSF President and CEO, Laurence Hubbard.

    Dividends are the result of better than expected return on investments and ​fewer than expected losses (accidents). Montana has historically been near the top of the list of highest on-the-job accidents and fatalities. While that ranking is trending in the right direction, there remains room for improvement.

    The $20 million dividend will be paid to more than 22,000 Montana employers. The average dividend is approximately $900, representing nearly a 15% return of premium––on average.

    ​”Over the years, Montana State Fund has consistently declared dividends, but this year is different. While today’s news is not related to COVID-19, it is our hope that the timing of this declaration provides some assistance to Montana’s Main Street businesses during these difficult times,” said MSF Board Chairman, Lance Zanto.​

    December Safety Workshops: Make Some Noise for Safety Training

    Sit comfortably at your desk as Montana State Fund safety services specialist Kirk Smith presents his virtual December safety workshop, “Make Some Noise for Safety Training” via Zoom.

    REGISTER NOW

    How will the workshops be run?
    The virtual workshops will include two topics, with one topic presented in the morning and the second topic in the afternoon. Each session will be scheduled for two hours with a break.  This breakdown gives participants time to step away from their computer to avoid any ergonomic or eye strain issues.

    Topics

    All Ears – In this section we will discuss the elements of a successful hearing conservation program. We will cover the physical attributes of the human ear, how hearing damage occurs, and the effect various levels of sound have on our hearing. We will then address the best way to determine if your employees are exposed to harmful noise levels, actions to limit these levels and the proper way to use hearing protection.

     Safety Training – One of managements greatest tasks is to create effective safety trainings.  In this section we will explore various training opportunities, introduce you to unique training methods, and discuss the philosophy behind safety training. We will then open the floor to participants as they talk about the challenges and accomplishments of safety trainings at their workplaces.

    Workshop Dates and Times

    Tuesday – December 8, 2020
    9:30 am – 11:30 am   Hearing Conservation Program
    2:00 pm – 4:00 pm    Safety Training

    Thursday – December 10, 2020
    9:30 am – 11:30 am    Safety Training
    2:00 pm – 4:00 pm     Hearing Conservation Program

    Wednesday – December 16, 2020
    9:30 am – 11:30 am   Hearing Conservation Program
    2:00 pm – 4:00 pm    Safety Training

    Interested?   Register Now.   All workshops are open to any Montana worker, but participants must register to receive a secure Zoom confirmation.  If you have questions, call 800-332-6102 extension 5361 (Kirk Smith).

    Growing the Next Safety Generation

    Montana State Fund’s (MSF) safety team busily mailed personal protective equipment to 37 construction trades and industry high school classroom across the state. This was made possible through MSF’s high school personal protective equipment (PPE) grant program.

    Traditionally, the MSF safety team personally visit the classrooms to convey the importance of safety in their classrooms and in the workplace. But with the uncertainty of Covid-19, an online safety video was produced.

    The selected classrooms were awarded up to $850 for the purchase of the PPE which could include safety eye protection, fall protection gear, gloves, and ear protection, suitable for the area of study. New this year, teachers were able to use a portion of their grant money to order safety equipment for their classroom such as machine guards, welding curtains or specialized PPE.

    The grants are part of Montana State Fund’s Growing a Safer Montana initiative to improve Montana’s workplace safety culture. The initiative teaches and reinforces positive safety in the classroom before these young people enter Montana’s workforce. Since the program’s inception in 2017, over $64,000 worth of safety gear has helped more than 5,000 students.

    Montana’s injury rate has decreased from 4.4 injuries for every 100 workers in 2017 to 3.9 injuries for every 100 in 2018. While that number is an improvement, it is still higher than the national average of 2.8. It is critical that we continue to teach and instill safety in the next generation of Montanan’s to help keep our injuries rates trending downward.

    Below is a list of the high schools, classrooms and teachers who received the safety equipment

    Anaconda High School Construction-Automotive
    Teacher: Brian Riley

    Anaconda High School Welding/Machining
    Teacher: Ryan Pesanti

    Arlee High School Woods & Welding
    Teacher: Michael Craig

    Beaverhead County High School (Dillon) Agriculture Education
    Teacher: Caleb Igo

    Belgrade High School Welding
    Teacher: Eric Kinnaman

    Belgrade High School Woodworking
    Teacher: Randy Radke

    Bozeman High School Welding Fabrication
    Teacher: Rick Hedlund

    Bozeman High School Woodworking
    Teacher: Daniel Brown

    Butte High School Welding
    Teacher: Denise Bordeleau

    Dawson County (Glendive) Welding Ag
    Teacher: Leanne Hoagland

    Drummond High School Carpentry & Welding
    Teacher: Alex Bolotsky

    Havre High School Automotive Tech
    Teacher: Tyler Kropf

    Havre High School Welding, Basic Metals
    Teacher: Christopher Comp

    Helena Capital High School Industrial Technology
    Teacher: Tom Kain

    Helena High School Welding
    Teacher: Cindy Galbavy

    Jefferson High School (Boulder) Welding
    Teacher: David Heimann

    Jefferson High School (Boulder) Woods
    Teacher: Mike Robbins

    Missoula Hellgate Building Trades, Math for the Trades
    Teacher: Charles Rinehart

    Missoula Hellgate High School Welding
    Teacher: Alan Pfister

    Missoula Sentinel High School Carpentry & Welding
    Teacher:Dave Burtch

    Park County High School (Livingston) Industrial Technology
    Teacher: Jamie Isaly

    Powell County (Deer Lodge) Cabinet & Carpentry
    Teacher: Clint Stevenson

    St. Regis High School Carpentry & Welding
    Teacher: George Cheesman

    Superior High School Construction/Drafting/Welding/Woods
    Teacher Jeff Schultz

    Whitehall High School Welding & Carpentry
    Teacher: Casey Harris

    The other part of the Growing a Safer initiative is academic scholarships for higher education students in the trades, such as welding, automotive and construction and those studying industrial hygiene or occupational safety and health. These scholarships will be distributed in January 2021. 

    For more information about the Growing a Safer Montana program contact Sophie Magnuson (406) 495-5397 or  Mark Rosenleaf (406) 495- 5334.

    Legislative Outlook 2021

    We have learned a lot over the last ten months. Our environments have changed, and we have had to adapt. Montana State Fund (MSF) is adapting, too. In the coming weeks and months, we will be rolling out new tools, sites and features to help our policyholders, injured workers and other stakeholders stay better connected.

    2021 is almost upon us. In Montana, odd-numbered years mean a regular session of the legislative body will convene in January. To prepare for the upcoming session, MSF will be launching a new interactive website to help you stay up to date on the latest happenings in Helena.

    Another feature we are rolling out is a podcast that we are calling Big Sky Business (BSB). BSB will be a periodic podcast featuring diverse content and guests that will hopefully add value to your day-to-day life.

    We are excited to work better together with you in the coming months and we look forward to unveiling new content and features very soon. In the meantime, if you would like to be placed on the BSB email list or you have any questions or comments, please email msflegislativeissues@safemt.gov.

    COVID-19 Coverage

    With the COVID-19 pandemic being prevalent at this time, Montana State Fund (MSF) has released  recommendations for clinics who are providing telephonic or virtual services to our injured workers during this crisis:

    We thank you for being flexible during this time and if you have any questions, please let us know.  We want to thank providers for continuing to see our injured workers in this time of uncertainty and wish everyone safety and wellness!  Please see below for approved telemedicine services for MSF:

    Note:  Please use POS 02 in Box 24B of the CMS 1500 form to indicate that the services provided have been via a telephonic/video type method.  The GT modifier may also be applied for audio/video telecommunications.  For timed codes, please document total time spent in the record.

    99201 – 99215 Evaluation and Management visits that normally require face to face time will be allowed as audio/video visits.  Documentation does need to support the services billed.

    Psychotherapy services

    90832:  30 minutes 90834:  45 minutes 90837:  60 minutes

    Psychological Evaluations will need to be authorized prior to service by calling Michele Fairclough, Director of Medical Services, at 406-495-5362.

    Online Digital Evaluation and Management service, for an established patient, for up to 7 days, cumulative, for up to seven days:

    99421:  5-10 minutes 99422:  11-20 minutes 99423:  21 or more minutes

    Telephone Evaluation and Management (E/M) services by a physician or other qualified health care professional who may report E/M services provided to an established patient:

    99441:  5-10 minutes 99442:  11-20 minutes 99443:  21-30 minutes

    Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient or episode of care initiated by an established patient:

    98966:  5-10 minutes 98967:  11-20 minutes 98968:  21-30 minutes

    Qualified non-physician health care professional online digital (non-face to face) E/M service utilizing internet resources for an established patient, for up to 7 days, cumulative time during those 7 days:

    98970:  5-10 minutes98971:  11-20 minutes 98972:  21 or more minutes

    Physical/Occupational Therapy can use the above codes as applicable; also, MSF will allow the following re-evaluation codes:

    97164 – Physical Therapy Re-evaluation 97168 – Occupational Therapy Re-evaluation

    The following Physical or Occupational Therapy initial evaluations will need to be pre-authorized by calling Michele Fairclough at the number listed at the end of this publication:

    97161 97162 97163 97165 97166 97167

    For physical/occupational therapies, MSF will allow the following codes for a total of 2 units (30 minutes) for the management of home exercise:

    97110 97530 97535

    We understand that there may be questions regarding different circumstances as we go along.  Please call Michele Fairclough, Director of Medical Services, at 406-495-5362 or Kym Vonada at 406-495-5389 and we will work toward getting these issues resolved.

    ECHO Update

    ECHO has been processing provider payments for Rising Medical Solutions on behalf of MSF for the past year. Payments automatically default and are made via Virtual Card.  For providers who are unable to accept payments via Virtual Card or prefer to receive a check or EFT, you will need to contact ECHO at 877-705-4230 and ask to “Opt out”.  This first opt out will only be valid for 300 days.  After 300 days, the payment will revert back to a Virtual Card.

    After 300 days, if you still wish a method of payment other than a Virtual Card, you must call ECHO and “Opt Out Permanently”. At that time the change will be permanent unless you choose to change the payment method in the future.

    Department of Labor & Industery (DLI) Fee Schedule Update 2020

    The Montana Department of Labor & Industry (DLI) has published the new Proposed amendments to the Professional and Facility fee schedules.  Hearing information can be found on the DLI website at http://dli.mt.gov/events/calendar.asp.  Highlights of changes are:

    Base Rates for Facility:

    Inpatient Hospital $8,909.00
    Ambulatory Surgery Center $       92.00
    Outpatient Hospital $     123.00

    Conversion Rates for Professional Services:

    Standard $63.41
    Anesthesia $67.32

    99080 – This code will be used to bill when a provider is responding to the Drug Formulary letters.

    See http://erd.dli.mt.gov/work-comp-claims/medical-regulations/montana-facility-fee-schedule-agreement​ for the July 2020 Instruction Set for the Facility Fee Schedule and https://mtwc.optum.com/ for the July 2020 Instruction Set for Professional Fee Schedule.  For any questions, contact Celeste Ackerman at 406-444-6604.

    Highlighting, Time Codes and Submitting Medical Records

    Highlighting Reminder – Please do not use a highlighter to draw attention to information that needs to be considered.  It does not scan well and may actually black out the information intended to be noticed.  Use a “star” method or underline/circle the information that you want highlighted.

    Time Codes When billing codes where time is an element, the time spent must be documented in the record for each timed code.  This information supports the number of units billed on the CMS 1500 or UB04 billing forms.

    Submit Medical Records Submit any medical records to STFMEDICALPROVIDER@MT.GOV .

    Save the Date – 2021 Medical Conference

    We are excited to announce that our 2021 medical conference will be held in the Fall of 2021 in Whitefish, MT at the Lodge at Whitefish Lake. This will be the first time we have hosted a medical conference outside of Helena.

    This conference promises to have a  dynamic line up of speakers and educational topics.

    In the meantime, if you have any questions please contact Shannon Hadley at 406-495-5245.

    2020 MTWCC 4 WCC No. 2017-4143 MICHAEL NEISINGER Petitioner vs. NEW HAMPSHIRE INS. CO. Respondent/Insurer

    FINDINGS OF FACT, CONCLUSIONS OF LAW, AND JUDGMENT

    Summary: Petitioner suffered a compensable left-leg injury and had surgery to repair his torn quadriceps. Thereafter, Petitioner developed severe low-back pain, with pain radiating into his hips and legs. Petitioner contends that his industrial accident aggravated his preexisting lumbar spine condition. Petitioner relies on the causation opinions of physicians and chiropractors, who in large part based their opinions on Petitioner’s statements that he had an immediate onset of pain from his lumbar spine at the time of his industrial accident or shortly thereafter. Respondent denied liability for Petitioner’s lumbar spine condition, maintaining that his industrial accident did not aggravate his preexisting lumbar spine condition. Respondent relies on the causation opinion of an IME physician, who determined that, based on Petitioner’s medical records, his onset of symptoms was approximately ten months after his industrial accident.

    Held: Respondent is not liable for Petitioner’s lumbar spine condition. Although Petitioner’s symptoms significantly worsened after his industrial accident, he did not meet his burden of proving that the industrial accident was the cause of the worsening. This Court gave more weight to the opinion of the IME physician because he was correct that the onset of Petitioner’s symptoms was approximately ten months after his industrial accident.

    Neisinger vs New Hampshire Ins. CO.