Provider Remittance Advice Revised

Effective November 29, 2017, WSI will begin issuing a revised Remittance Advice to medical providers. The Remittance Advice is a notice sent as a companion to a medical bill payment, which explains the adjudication of a bill.

Below is a summary of the significant changes to the Remittance Advice:

• Change in page orientation from portrait to landscape view, which enables a greater amount of information to display.
• Horizontal line breaks to separate injured workers’ bills from one another.
• Addition of new columns including WSI Fee Schedule, Injured Worker Responsibility, Provider Responsibility, APC Return Code.
• Addition of a new column for reporting of Revenue Code or DRG Code separate from reporting of CPT® or other procedure codes.
• Addition of DRG Code and APC Return Code descriptions, located at the end of the Remittance Advice.

Refer to the Provider Remittance Advice section of our website for additional information.

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