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Good Morning
10:22:52 AM CDT
Monday, May 25, 2015

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How To Bill

The appropriate bill forms for submitting charges include CMS 1500, UB 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 requires submission of typed medical documentation to support the charges billed. Providers may submit medical bills in the following formats:

Paper
Providers submitting bills in red and white paper format should mail bills with supporting medical documentation to:

Workforce Safety & Insurance
PO Box 5585
Bismarck, ND 58506

Electronic
For EDI submission of medical bills, providers should contact Noridian EDI Support Services at 800-967-7902.
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