A provider should review the reason code to determine if the denied or reduced charge is eligible for an appeal. The Medical Bill Appeal (M6) form initiates a second bill review process for medical treatment or goods to dispute the amount of payment
Complete M6 form and return with supporting documentation to WSI:
Workforce Safety & Insurance
PO Box 5585
Bismarck, ND 58506-5585
- Fax: 701-328-3765 or 888-786-8695
When to Rebill
A provider should submit a corrected bill if they billed the wrong CPT code, incorrect units or have delayed charges.