Billing for medical services

In the Health Partnership Program, medical providers must submit fee bills to the injured worker’s managed care organization (MCO) either in hard-copy or electronic format.

Click here to find MCO billing addresses.

BWC and the MCOs prefer the electronic format, ASC X12 837.

When you submit bills, follow the policies and guidelines detailed in BWC’s Billing and Reimbursement Manual (BRM). You can download and print specific chapters of the manual or you can order a hard copy of the entire manual online. BWC-certified providers automatically receive quarterly BRM updates, which are also available online.

To ensure consistency and maintain quality customer service, all BWC-certified MCOs accept the following national and BWC billing forms:

• American Dental Association (ADA) dental form;
• CMS-1500
• Health Care Finance Administration (HCFA)-1500;
• Uniform Billing (UB-04);
• BWC Service Invoice (C-19).

To avoid delays, please do not bill the injured worker or the employer for services provided in state-fund claims. Also note that self-insured claims are not part of HPP. Self-insuring employers pay for their employees’ workers’ compensation benefits. Therefore, when providing services in self-insured claims, send medical bills directly to the self-insuring employer.