Transforming Medical Bill Review for Montana Municipal Interlocal Authority

The Challenge
The Montana Municipal Interlocal Authority (MMIA) provides critical services to Montana’s incorporated cities and towns, offering self-funded coverage for employee benefits, liability, property, and workers’ compensation. Despite their crucial role in supporting Montana’s municipalities, MMIA was handling their entire medical bill review process manually in-house—a time-consuming approach that pulled valuable resources away from other essential tasks.
Client
Montana Municipal Interlocal Authority (MMIA)
Implementation Time
30 days
Key Achievement
Fully automated medical bill review system with claims management integration
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The Solution

After evaluating multiple vendors, MMIA partnered with Preferred Medical to revolutionize their medical bill review process. The partnership focused on three key areas:

1

Montana-Specific Compliance: Development of custom rules and guidelines aligned with state regulations

2 Process Optimization: Creation of streamlined workflows tailored to MMIA’s unique needs

3 System Integration: Implementation of a custom EDI solution that works seamlessly with MMIA’s existing Origami claims management system

Key Features Implemented
Daily Data Synchronization: Automated exchange of claims eligibility, provider information, and billing data
Custom Payment Processing: Special handling for attorney-represented claims with Lockhart Lien policy considerations
Streamlined Provider Communication:
  • Direct reconsideration routing to Preferred Medical
  • Dedicated provider service center
  • Self-service provider portal for bill and payment status checks
Full Platform Integration: Seamless data exchange between bill review and claims platforms
Rapid Processing: Three-day average turnaround time for bill reviews

Business Impact

The implementation transformed MMIA’s operations in several crucial ways:

  • Enhanced Efficiency: Examiners freed to focus on high-priority tasks
  • Improved Provider Relations: Faster payments and better communication channels
  • Reduced Administrative Burden: Automated workflows replaced manual processes
  • Strengthened Compliance: Customized rules ensure adherence to Montana regulations
MMIA Representative

“We manually processed all provider bills in-house prior to our relationship with Preferred Medical. We needed to find a partner that would allow our team to focus on their top priorities as well as provide the expertise needed to ensure we maintained compliance. From the beginning of the relationship, Preferred Medical worked with us to understand our unique needs and then customized their solution for us. This includes building an integration with our claim system within 30 days and at no cost to us.”

The Preferred Medical Difference

What set this implementation apart was the speed and precision of execution. While similar EDI solutions typically require 12-18 months to implement, Preferred Medical delivered a fully functional, custom-integrated system in just 30 days. This rapid deployment, combined with the comprehensive nature of the solution, showcases our commitment to delivering exceptional value to our partners.

Looking Forward

The partnership between MMIA and Preferred Medical demonstrates how the right technology solution, properly implemented, can transform resource-intensive processes into streamlined operations. This successful implementation has set the foundation for continued improvements and innovations in MMIA's medical bill review processes.