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:
 

Paper

A provider may submit a paper bill in the original red and white format with supporting medical documentation to WSI:

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

 

Electronic

A provider may submit medical charges via EDI through one of WSI’s clearinghouses:

  • iHCFA: This option allows a provider to submit professional (CMS-1500/837p) charges along with supporting medical documentation. Contact iHCFA EDI Support Services at 973-795-1641 (option 2) for additional information.
  • Noridian: This option allows a provider to submit professional (CMS-1500/837p) and institutional (UB-04/837i) charges without medical documentation attachment through Noridian. A provider must mail all supporting medical documentation to WSI at the address provided above or fax it to 701-328-3793. Contact Noridian EDI Support Services at 800-967-7902 for additional information.