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
Contact Us
