Section 20-2-II - INSTRUCTIONS TO PROVIDERSA. All bills for service must be coded with the appropriate CPT, CDT, HCPCS or state-specific code. B. The medical provider must file the appropriate billing form and necessary documentation within twenty (20) days of rendering services on a newly diagnosed work-related injury or illness. Subsequent billings must be submitted at least every thirty (30) days, or within thirty (30) days of each treatment or visit, whichever last occurs, with the appropriate medical records to substantiate the medical necessity for continued services. Late billings will be subject to discounts, not to exceed one and one-half percent (1.5%) per month of the bill or part thereof which was not timely billed, from the date the billing or part thereof is first due until received by the payer. Any bill or part thereof not submitted to the payer within sixty (60) days after the due date under this rule shall be subject to an additional one-time only discount penalty equal to ten percent (10%) of the total bill or part thereof. Any bill for services rendered which is not submitted to the payer within one (1) year after the date of service, or date of discharge for inpatient care, will not be eligible or considered for reimbursement under this Fee Schedule, unless otherwise ordered by the MWCC or its Cost Containment Division. C. When services were rendered by another qualified health care professional and billed under the physician's National Provider Identifier (NPI), the billing physician must sign the medical record. When the physician bills the E/M services, the physician must personally document that the physician performed the service or were physically present during the critical or key portions of the service furnished by the qualified health care professional, and the physician's participation in the management of the patient. D. Fees in excess of the maximum allowable reimbursement (MAR) must not be billed to the employee, employer, or payer. The provider cannot collect any non-allowed amount (MCA § 71-3-15(3) (Rev. 2000)). E. If it is medically necessary to exceed the Fee Schedule limitations and/or exclusions, substantiating documentation must be submitted by the provider to the payer with the claim form. F. If a provider believes an incorrect payment was made for services rendered, or disagrees for any reason with the payment and explanation of review tendered by the payer, then the provider may request reconsideration pursuant to the rules set forth herein. G. If, after the resolution of a reconsideration request or a formal dispute resolution request, or otherwise, the provider is determined to owe a refund to the payer, the amount refunded shall bear interest at the rate of one and one-half percent (1.5%) per month from the date the refunded amount was first received by the provider, until refunded to the payer.