Submit Professional Bill

To submit information for a new professional bill:

Access this page using the method below that applies to you:
- WCMBP Users: In the Bills menu, click the Submit Professional hyperlink.
- Provider Portal Users: From the Provider Portal home page, select the On-line Bills Entry hyperlink. At the Online Bills Entry page, select the Submit Professional hyperlink.

The system displays the Professional Bill page.

Select the indicator from the Special Indicator drop-down.
Select the program from the Program drop-down list.
Under the Provider Information section, enter the required provider ID in the Provider ID field, and the select OWCP ID from the Type drop-down.

Once you have entered the required data, the system refreshes the Professional Bill page with the Provider Name and Address details populated.

Note: The Provider Name, City, State, and Country details are auto-populated and they are disabled as the provider is already enrolled in the WCMBP system portal. You can make edits only to the address by clicking on the Address hyperlink.

The remainder of the Provider Information section consists of expandable grids that each asks a Yes or No question. The grid expands to show additional fields to be filled in according to your answer.

Answer Yes or No to the following grid questions:

Is the Billing Location also the Service Facility Location? – If you answer No, the grid expands. Enter the Servicing Facility Provider ID in the Servicing Facility Provider ID field, and select NPI from the Type drop-down.

The system automatically refreshes the Professional Bill page with the Servicing Provider Name and address fields populated. These fields are view-only. You can make edits only to the address by clicking on the Address hyperlink.

Is the Billing Provider also the Rendering Provider? – If you select No, the grid expands. Enter and select the rendering provider’s details in the Provider ID, Type, and Taxonomy Code fields.
Is the Billing Provider also the Supervising Provider? – If you select No, the grid expands. Enter and select the supervising provider details in the Provider ID and Type fields.
Is this service the result of a referral? – If select Yes, the grid expands. Enter and select the referring provider details in the Provider ID and Type fields.

In the Claimant Information section, enter the claimant ID in the Claimant ID field, and select Case Number from the Type drop-down.

The system automatically refreshes the section with the rest of the claimant information fields populated. You can make changes to these fields if needed.

If the bill has third-party liability, select Yes at the grid question, Does Bill have any Third Party Liability Amount? The grid expands so you can enter the amount in the Third Party Liability Amount field.
In the Bill Information section, click the plus sign next to the Relevant Dates sub-heading and enter dates for the fields as needed in the expanded subsection.
Enter the prior authorization number in the Prior Authorization Number field, if applicable.
Select the plus sign next to the Bill Note sub-heading and enter a note in the Bill Note text box if needed.
Answer Yes or No to the grid question, Is this bill accident related?

If you answer Yes, the grid expands so you can specify the causes from the Related Causes drop-downs and enter the date of the accident in the Accident Date field.

If applicable, select the state where the auto accident occurred from the Auto Accident State drop-down.

Under the Bill Data heading, enter the patient account number in the Patient Account No. field.
Select the place of service from the Place of Service drop-down.
Select the diagnosis code category from the Diagnosis Code Category drop-down and enter the diagnosis codes in the Diagnosis Codes fields.
If applicable, enter the required codes in the Anesthesia Related Procedure, Condition Information, and Delay Reason expandable sub-headings.
Under the Basic Line Item Information section, at a minimum, enter the required fields.
Answer Yes or No for the Is the Header Service Facility Location also the Service Line Facility Location question. If you answer No, the grid expands. Enter the Servicing Facility Provider ID in the Servicing Facility Provider ID field, and select NPI from the Type drop-down.

Select the plus sign next to the Line Drug Information sub-heading to enter any required drug information on the bill.
When you are finished on the page, click the Add Service Line Item button.

The system updates the Professional Bill page and displays the submitted details in the Line Item Information list at the bottom of the page.

If necessary, click the Line No. hyperlink at the bottom of the page to make any changes to the line information and then click the Update Service Line Item button.
Select Submit Bill.

The system displays a pop-up message asking if you want to submit any backup documentation.

Select OK.

The system displays the Backup Documentation page.

Select Browse to select the file to be uploaded as backup.

Note that only PDF, TIF, or TIFF files can be selected.

Select OK.

The system displays the Submitted Professional Bill Details page with the newly generated TCN.

Select Submit to process the bill for adjudication.

The system displays a dialog message saying that the bill was submitted successfully.

Select OK to return to the Professional Bill page and add another bill.

You can view the newly generated bills in the Inquire Bills section.

In the Inquire Bills list page, click the TCN hyperlink for the bill that you want to view.

The system displays the bill with the updated Bill Status and the Processing Status as Edits Processed.

Submit Professional Bill

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