Submitting bills through a clearinghouse

If you want to use a clearinghouse to bill L&I electronically, you will need to designate the company and provide permission for the clearinghouse to bill on your behalf.

Follow these 2 simple steps:

• Complete an Electronic Billing Authorization form (F248-031-000). If you want to authorize a clearinghouse to receive an electronic 835 or Proprietary remittance advice file, complete a Power of Attorney for Electronic Remittance Advice (F248-355-000) and fax it along with the billing authorization.
• Fax the completed form(s) to 360-902-6192.

L&I will update your account and notify the clearinghouse when they are set up in our system to bill for you.

When you are ready to bill electronically, you will need to coordinate with your clearinghouse.

Note: If you need a payer ID, contact your clearinghouse.  Often, clearinghouses will post a list on their website.

 

Information for Clearinghouses

You must be able to create files in the HIPAA compliant 837 format.  The following guides are available to you or your software support staff to assist you if needed:

• HIPAA 5010 Companion Guide (1.83 MB PDF)
  • EDI X12 837 Professional
  • EDI X12 837 Institutional
  • 835 Remittance Advice
• HIPAA 4010 Companion Guide (605 KB PDF / 3 min).
  • EDI X12 837 Professional
  • EDI X12 837 Institutional
  • 835 Remittance Advice
• Pharmacy remittance advice (381 KB PDF).

Follow these 4 simple steps:

• An active L&I provider account (submitter ID) number is required to bill L&I.  Complete the Provider Account Application and Notice form (F248-011-000).
• Create a secure account within My Secure L&I (powered by SecureAccess Washington).
• Submit electronic test file(s) until approved to submit production files.
• Make sure that the provider has completed an Electronic Billing Authorization form (F248-031000). If the provider wants you to receive an electronic 835 or Proprietary remittance advice file, they will also need to complete a Power of Attorney for Electronic Remittance Advice (F248-355-000). You or the provider should fax the completed forms to 360-902-6192.

L&I will notify you when you’re authorized to bill on the provider’s behalf.

Need more help?

For more information, see the Frequently Asked Questions or contact:

Electronic Billing Unit
Phone: 360-902-6511
Email: ebulni@Lni.wa.gov