When to request an adjustment

  • If you made a mistake when you billed L&I and it caused an underpayment or overpayment.
  • If we paid an entire bill in error and you want us to reverse the charges.

How to submit an adjustment

If you submitted your bill by way of:

  • Clearinghouse or your own software - Submit an adjustment transaction through your clearinghouse or software program. If you need additional assistance, please contact your clearinghouse or software vendor.
  • Direct Entry – please follow the instructions in the Adjust, Submit, or Void a Direct Entry Bill (F245-437-000) document.
  • Paper – Complete a Provider’s Request for Adjustment form (F245-183-000).

For more information about billing electronically, please visit our Provider Express Billing (PEB) page.

When to re-bill

  • If the entire bill has denied.
  • If your bill was denied due to lack of authorization see retrospective authorization.

Disagreements with L&I

If you disagree with an L&I decision, you can protest or appeal.