nd.gov - The Official Portal for North Dakota State Government
North Dakota: Legendary. Follow the trail of legends
Workforce Safety & Insurance Logo Top of the page place holder

   
Contact Us       About Us       News       Careers       Calendar       Free e-Newsletter       RFI/RFP       Links       Site Map      
spacer image
gray hexagon imagespacer imageForms/Library 
red hexagon imagespacer imageEmployers 
orange hexagon imagespacer imageWorkers 
yellow hexagon imagespacer imageMedical Providers  green hexagon imagespacer imageSafety & Loss Control 
purple hexagon imagespacer imageOnline Services 
tan hexagon imagespacer imageFraud Awareness 
spacer imageHOME 


Good Morning
11:02:16 AM CDT
Monday, May 04, 2015

spacer image
Billing left Header Billing right Header
Payment Adjustment
There are two levels to appeal a denied or reduced charge.

Return the completed form with supporting documentation to:

Workforce Safety & Insurance
PO Box 5585
Bismarck, ND 58506

Fax: 701-328-3765 or 888-786-8695

When to Rebill
Providers should submit a corrected bill if they billed the wrong CPT code, incorrect units or have delayed charges.
spacer image

Back to Top 

Employers | Workers | Medical Providers | Safety | Online Services | Fraud Awareness | Forms/Library 
Home | Contact Us | About Us | News | Careers | Calendar | Free e-Newsletter | Links | Site Map

2013 Workforce Safety & Insurance | comments: wsiwebmaster@nd.gov
 

Section 508 Accessibility Link    CSS Validation Link