New Electronic Data Interchange (EDI) Option Available for Professional Billing

April 2017

Effective immediately, a provider may submit professional charges (CMS-1500/837p) and documentation electronically to WSI through iHCFA. WSI is also working to implement submission of institutional charges (UB-04/837i) through iHCFA.

iHCFA is a specialized clearinghouse that offers the electronic submission of bills, medical reports, and supporting documents to workers' compensation payers. This new billing option will result in quicker bill payment, confirmation reports of bill receipt, and elimination of paper and associated expenses for a provider.

iHCFA provides the following options for submitting professional medical bills, which were not previously available:

  • Direct connection with WSI for medical bill and documentation submission
  • Online claim form interface, including documentation attachment
  • Indirect connection with a provider’s existing clearinghouse, dependent on the clearinghouse’s ability to meet certain technical requirements

A provider interested in submitting professional (CMS-1500/837p) bills via EDI must register with both WSI and iHCFA.

  • To register with WSI, complete the Payee Registration and Substitute W-9 form. WSI requires a new or an existing provider complete this form prior to submitting through iHCFA. A provider must submit a Payee Registration and Substitute W-9 form for each business NPI they bill to WSI.
  • To register with iHCFA, or for additional information, contact iHCFA at 973-795-1641 (option 2).

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