Montana Municipal Interlocal Authority (MMIA) Case Study


The Montana Municipal Interlocal Authority (MMIA) is a member-owned and member-driven organization that provides self-funded employee benefits, liability, property, and workers’ compensation coverage to incorporated cities and towns of Montana. MMIA was established so that cities and towns could achieve the stability they needed when the commercial insurance market was unavailable as a resource. MMIA pools the resources of its municipal members to provide quality, cost-effective self-funded coverage, and risk management services.


MMIA had been utilizing in-house resources to manually carry out their Medical Bill Review process for many years. However, the organization knew this process could be improved and began searching for an optimized Medical Bill Review solution. After vetting multiple vendor programs, Preferred Medical was selected as MMIA’s partner for this initiative due to our detailed expertise in Medical Bill Review, ability to implement a full, customized solution within a very quick timeframe, and unique vision that defines what an integrity-based medical bill review partnership should entail.


Working together to identify the optimal plan was critical as it would ensure full compliance with Montana’s regulations and fulfill the need for redundancy around this important process.

Preferred Medical immediately began working with MMIA to:

  • Author the rules and guidelines for Montana-based Medical Bill Review
  • Outline the process for Medical Bill Review to best meet MMIA’s needs
  • Identify how to implement the Medical Bill Review solution leveraging MMIA’s existing claims management system


One of the real differentiators of working with Preferred Medical is our ability to quickly build and implement a robust solution that integrates with our clients’ existing IT infrastructure. In this case, Preferred Medical built and launched a custom Electronic Data Interchange (EDI) solution with MMIA’s existing claims management system, Origami. A process that can often take 12-18 months for a custom and effective EDI solution, was completed in 30 days.

Key features of the custom solution built for MMIA include:

  • Custom-built claims eligibility, provider entity, and bill data files are delivered daily from MMIA to Preferred Medical to help ensure data integrity between the two platforms.
  • A file is then returned to MMIA with final review details that ensures the correct capturing of the service & billing provider, MMIA-specific pay codes, along with line by line review details for reach bill reviewed.
  • An entirely customized solution – for example, certain claims have attorney representation whereby the attorney is exercising the Lockhart Lein policy and therefore receives a partial payment allowance of what’s owed to certain providers.
  • A custom workflow to allow providers to route reconsiderations directly to Preferred Medical instead of to MMIA directly, which saves time and energy for the examiners. The solution does not compromise the examiner’s ability to have visibility into incoming bills.
  • Preferred Medical serves as a provider service center for MMIA’s providers inquiring about bill payment status and EOR questions, mitigating the number of calls from providers to MMIA.
  • Access for billing providers to log into a provider portal to check on bill & payment statuses.
  • Complete data exchange between Bill Review and Claims platforms, which eliminates the need for the examiner to access an additional portal.
  • Quick turnaround time, averaging three business days from receipt of bill to review completion.
  • Proactive problem identification with a speedy & effective resolution process.

The benefits of the custom solution implemented, include:

  • The ability to pay providers quickly
  • More time for examiners and team members to focus on the most important aspects of their jobs
  • Building outstanding relationships with MMIA’s network of providers

“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 included building an integration with our claim system within 30 days and at no cost to us. This custom electronic data interchange allows Preferred Medical to receive the necessary information and then return the data file with final review details saving our examiners significant time. They also have served as a key point of contact for our providers, which has improved our relationship with the providers as well as saved our team time and energy responding to inquiries. Preferred Medical has proven to be a great partner for us, and we look forward to continuing to work with them to improve our medical bill review processes.”

– Montana Municipal Interlocal Authority