How to Bill

The appropriate bill forms for submitting charges include CMS 1500UB 04, or ADA Dental. WSI accepts the current AMA CPT® codes and modifiers, excluding consult codes. Out-of-state specific codes or guidelines are not accepted.

Billing Options

WSI offers the following options for submitting a medical bill and supporting documentation:
A provider may submit a CMS 1500 or UB 04 in the original red and white format with supporting medical documentation to WSI:

Workforce Safety & Insurance
PO Box 5585
Bismarck, ND 58506-5585

A provider may submit 837P and 837I EDI transactions through one of WSI's clearinghouses:

  • iHCFA: WSI's preferred clearinghouse vendor is iHCFA. iHCFA offers electronic medical bill submission with electronic documentation attachment.  In addition, users receive automated notification of WSI's receipt of a medical bill. Submission through iHCFA is available at no cost to the provider.  Contact iHCFA EDI Support Services at 973-795-1641 (option 2) for additional information.
  • Noridian: Noridian offers electronic medical bill submission without documentation attachment. A provider must mail all supporting medical documentation to WSI at the address provided above or fax it to 701-328-3793. Users do not receive notification of WSI's receipt of a medical bill. Cost for bill submission is negotiated through Noridian directly. Contact Noridian EDI Support Services at 800-967-7902 for additional information.