minnesota workers’ compensation e-billing information

The following information is being provided pursuant to Section 1 of House File 2193 subdivision 7a in MN ST s 176.135.

The Name and ID # of each clearinghouse with which Westfield Insurance has an agreement to exchange or transmit electronic transactions:

Payer Billing Clearinghouse

NAME:                    Jopari Solutions

ID NUMBER:         20-0787505

Information about how a health care provider can obtain the claim number assigned by Westfield Insurance for an employee’s claim and how the provider should include the claim number when submitting a bill:

Westfield Insurance Contact Information:

PHONE:                 800.243.0210, Option 3

EMAIL:                  WestfieldCCC@Westfieldgrp.com

All HFCA 1500 and UB92 billing forms should be submitted with associated medical documentation. The claim number must be on all documents. If you are unaware of the correct claim number, please obtain from the injured worker or by contacting Westfield Insurance as outlined above.

The name, phone number, and email address of contact persons who can answer questions concerning electronic transactions on behalf of Westfield Insurance:

Jopari Solutions, Inc.

CONTACT:            Provider/Customer Support

Genex Services

CONTACT:            MRS Compliance Supervisor
                                484.679.4102, extension 13383