As a provider, you start the billing process when you
submit your bill to the appropriate managed care organization (MCO). The entire process takes 21 days.
The MCO must either reject the bill, if information on the bill is missing or invalid, or process the bill within seven days
of receiving that bill. If the MCO rejects the bill, it will be returned to you with an explanation of the missing or invalid
information. If the bill contains all of the required information, the MCO will edit and price the bill, then electronically
transmit it through BWC’s bill system, which validates pricing and claim status. You will receive the lesser of the billed
amount, the BWC fee schedule amount or the MCO panel amount, if
you are member of the particular MCO’s panel.
BWC electronically transmits the payment and remittance information to the MCO within seven days of receiving the bills. The
MCO releases payment and remittance information to providers within seven days of receiving payment from BWC.
