New Process to Enforce Use of Medical Bill Appeal (M6) Form

June 2016

Effective July 1, 2016, WSI will implement a new process to enforce the exclusive use of the Medical Bill Appeal (M6) form. A provider who wishes to dispute a bill denial or payment reduction must complete the M6 form and submit it with supporting documentation within 30 days of the remittance advice date. WSI will send a rejection letter in response to any appeal received without the M6 form.

To expedite the appeal process a provider should complete the M6 form in its entirety, including a detailed reason for the appeal. In addition, it is important for a provider to review the Remittance Advice Reason Code description to determine the reason for a bill denial or reduction of payment and the appeal eligibility.

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