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How to bill for your services
You can bill two ways:
- Electronic billing (L&I only).
- Paper billing (L&I or self-insured).
Use these codes and policies to bill L&I.
Electronic billing (L&I only)
Before you can start billing L&I electronically, submit an Electronic Billing Authorization form (F248-031-000).
When you are authorized, you will go to the Provider Express billing site to bill L&I.
For more information, you can contact:
- Electronic Billing Unit
Dept of L&I
PO Box 44263
Olympia, WA 98504-4263
360-902-6511
Note: The Crime Victims Program does not have electronic billing available.
Paper billing (L&I or self-insured)
To bill L&I, use these forms, if the client is:
- An injured worker: Statement for Miscellaneous Services form (F245-072-000). Here is an example of a completed Statement for Miscellaneous Service form.
- A crime victim: Statement for Crime Victim Miscellaneous Services form (F800-076-000).
Billing a self-insurer is different than billing L&I. This can vary depending on the self-insurer. To determine insurer call 360-902-6901.
Get a copy of the Miscellaneous Services Billing Instructions manual by calling the Provider Hotline and requesting one.
Do I have to show proof of the time I interpreted for the client(s)?
Yes, you must show proof using one of the options below. Here is an example of a completed Interpretive Services Appointment Record form.
- The Interpretive Services Appointment Record form (F246-056-000) or
- The doctor's form or
- The language agency's encounter form.
If you choose to use the provider's form or the language agency's encounter form,
see what information the form must contain.
The upper right-hand corner of the form must show the:
Claim number,
Client's full name and
Date of injury.
Also on the form:
The interpreter's name and language agency's name, if applicable.
Appointment information including:
Healthcare or vocational provider name,
Appointment street address,
Appointment date,
Appointment start time,
Interpreter arrival time,
Appointment completion time and/or
If a group appointment, total number of clients participating.
Mileage information including:
Miles from starting location (street address) to appointment,
Miles from appointment to next appointment or return to starting location and
Total miles.
Verification of the appointment is done by the healthcare or vocational provider and includes:
Printed name and signature of person verifying services, and
Date signed
Do I have to show proof of mileage ?
Yes, you must show proof by sending a printout from a software mileage program and name of software program used to the claim file.
Interpretive Services Appointment Record form and mileage verification must be in the claim file at the same time you bill the insurer or your bill may not be paid.
Individual Interpretation Services: You must bill services for the same client, for the same date of service, on one bill or your bill may not be paid.
Group Interpretation Services: Time and mileage is divided between all clients participating in group.
Send a separate bill for each client with prorated amounts. Send Interpretive Services Appointment Record form and mileage verification to each L&I client’s file.
Do not staple Interpretive Services Appointment Record form and mileage verification to bill forms.
Fax or send documentation separately from bills for State Fund or Crime Victims Compensation Program claims to:
| State Fund - We prefer you fax the documentation. | |
Fax Numbers:
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Mail:
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| Crime Victims Compensation Program Department of Labor and Industries PO Box 44520 Olympia, WA 98504-4520 (360) 902-5377 1-800-762-3716 |
Self-insurer Varies – to determine insurer call (360) 902-6901 OR see Self-insurer list |
Send State Fund Bills to: |
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Can I be paid to translate a document?
You can only be paid when it is requested by L&I or the self-insurer.
What can I do if part of my bill is denied?
You can request a reconsideration if your bill was partially paid. To request reconsideration of denied charges:
- For L&I claims, see our Protest L&I Decisions web site.
- For self-insured claims:
- Request reconsideration directly to the self-insurer.
- If you cannot resolve the issue with the self-insurer, you can contact L&I's Self-Insured Section at 360-902-6901.
Adjustment vs. Submitting a New Bill
- When the whole bill is denied, then you need to submit a new bill.
- When part of the bill is paid, then you do an adjustment using the "Provider Request for Adjustment" form. Additional information on adjustments is available at http://www.lni.wa.gov/ClaimsIns/Providers/Billing/BillLNI/PayAdjust/default.asp.
If the time or mileage needs to be corrected you should adjust the last paid bill.
Use these codes and policies to bill L&I.
If you have questions, please contact Cecilia Maskell or call 360-902-5161.
