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Billing Guide

This Billing Guide outlines West Virginia’s workers' compensation billing requirements and DaisyBill’s resources for filing compliant medical bills.

Billing Form Requirements

This table is a guide to DaisyBill's resources on the required forms for compliant paper and electronic workers’ comp billing in West Virginia.

Forms

Services

DaisyBill Resources

CMS-1500 (HCFA)

Professional Services

CMS-1500 Instructions

UB-04

Facility

NCPDP

Pharmacy

Not Specified

Dental

State-Mandated Reporting Requirements

This table is a guide to DaisyBill's resources on the reporting forms required for compliant paper and electronic workers’ comp billing in West Virginia.

Attachment Description

Days until Due

 Form

Initial Physician’s Report

 

Attending Physician's Report

Attending Physician's Report (PDF)

Electronic Billing Mandate

The West Virginia Offices of the Insurance Commissioner have not issued electronic billing regulations or rules for medical bills. Accordingly, contact the payer to determine if workers’ comp bills can be submitted electronically.

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