Same Certification. Different Approach.

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Rules and Timeframe for Bill Payment Process

Bill Reimbursement Process

When Spooner MAI receives a bill, we provide clinical editing reviews before submitting it to the BWC. Once the bill is approved by the BWC, we will process it and mail a check to the billing provider. The table below shows the expected timeframe:

Days Activity
1-7  Spooner MAI enters the bill and ensures the bill is valid. If the bill is not valid, a letter is sent back explaining why. If the bill is valid, then Spooner MAI clinically edits and reprices the bill and submits it to the BWC
8-15 BWC reviews the bill and transfers the funds to Spooner MAI.
16-22 Spooner MAI prints and mails the check.

Common Reasons why Payment is Delayed:

  • Needed medical documentation is not submitted with the bill
  • The claim or billed ICD9 is not in a payable status
  • Billing provider is not BWC certified
  • Missing required data items
  • NPI # provided not registered with BWC and no WCID # provided
  • No prior authorization for treatment or prior authorization has expired

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