Billing/Payment

Billing/Payment contains information to use in conjunction with Provider News, the Utilization Review Guide, and other WSI publications. It is subject to change at any given time without notice. Coverage decisions are subject to claims decisions, fee schedule guidelines, and applicable state laws. Information contained in this section does not constitute authorization of services.

Provider Registration

Prior to reimbursement for a medical service, a provider must complete the Medical Provider Payee Registration form to register with WSI. The provider registration establishes a provider's payment, correspondence, and medical record information.

The following are main elements pertaining to how WSI sets up a medical provider payee account:

  • WSI utilizes the Taxpayer Identification Number and the billing National Provider Identifier (NPI) as the main identifiers to set up a medical provider payee account.
  • WSI sets up a single medical provider payee account for each unique billing NPI, regardless of the number of service locations that share this same NPI.
  • WSI expects the billing NPI registered to be submitted in Box 33a of the CMS-1500, Box 56 of the UB-04, or in the corresponding 837P and 837I fields for electronic billing.