Red and White Forms Required for Medical Billing

November 2014

Effective January 1, 2015 WSI will adopt CMS guidelines, which require red and white versions of the CMS 1500 and UB-04.

WSI will not accept black and white versions of the CMS 1500 and UB-04 forms, including photocopied or faxed forms. Forms that are not red and white versions will reject and the provider will receive notification to resubmit on the proper claim form.

WSI nor CMS supplies the form to providers for claim submission; blank forms are available through office supply stores. Providers should not download a copy of the form for submission of bills, as the copy may not replicate the colors and scale required of the form.

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