Background Due to a recent policy change, Medicare may not review or pay bills for individuals who currently have an open workers’ compensation claim with Workforce Safety & Insurance (WSI) even when the treatment was not related to a work injury. Your medical provider or Medicare may ask you to close your workers’ compensation claim before Medicare will review or pay a bill. By law, WSI cannot close a claim until there have been no benefits paid within the last 4 years.
What you can do
The 2 different scenarios you may experience regarding Medicare billing issues are outlined below with the recommended steps.
- Scenario 1 – Medical treatment is related to your work injury If you believe the medical treatment you received is related to your work injury, contact your medical provider to request they send the bills to WSI for review.
- Scenario 2 – Medical treatment is unrelated to your work injury If you believe the medical treatment you received was unrelated to your work injury and receive notice of a billing issue, contact WSI to send an update to Medicare regarding your work injury information.
If Medicare has already denied your bill, follow Medicare’s appeals procedure found on the Medicare Summary Notice and contact WSI to send an update to Medicare regarding your work injury information.
How to reach WSI
Contact WSI using one of the methods listed below and indicate you have a Medicare billing issue. Provide your Medicare number and, if applicable, the denied date of service.
Telephone number: 800-777-5033 or 701-328-3800
Email: [email protected]
Fax number: 888-786-8695 or 701-328-3820
Mail: PO Box 5585, Bismarck ND 58506-5585