Electronic Medical Billing

Submitting Medical Bills Electronically

State Fund accepts electronic bills (e-bills) for medical goods and services, as defined by California Labor Code 4603.4. Interested providers may contact one of State Fund’s clearinghouse partners listed below for more information about e-billing or to sign up for our e-billing program. Providers who have established partnerships with clearinghouses other than Jopari Solutions Inc. or StoneRiver P2P Link may submit e-bills and attachments to State Fund via those existing partnerships.

Tax Identification Number (TIN)

If you are a first-time provider for State Fund, you must also complete and return an Internal Revenue Services form W-9 or form 5159 prior to submitting your e-bill to our clearinghouse. Your bill (paper or electronic) will not be processed until your Taxpayer Identification Number (TIN) is stored within State Fund’s vendor file. Please review our Single Remittance Address Policy regarding your TIN.

E-billing Regulations

The California Division of Workers’ Compensation (DWC) adopted regulations and standards in 2012, to encourage medical providers to transition to e-billing, improve efficiency of the billing and remittance process, and produce quicker bill payment. Title 8 of the California Code of Regulations covers workers’ compensation medical billing rules and requirements. To assist providers with electronic billing and remittance, the DWC created a guide called “Electronic Medical Billing and Payment Companion Guide.” State Fund will only accept paper bills served in accordance with 8 CCR §10625(b)(1), 10625(b)(2), 10625 (b)(3), or electronic bills compliant with The California Division of Workers' Compensation Electronic Medical Billing and Payment Companion Guide. State Fund does not agree to, and will not accept, bills served in any other manner, including, but not limited to, bills transmitted by facsimile (fax) and e-mail.

To obtain clarification or answers to questions regarding the regulations, please contact:

DWC - Medical Unit
P.O. Box 71010
Oakland, CA 94612
Attn: Electronic Billing
Phone: (510) 286-3700 or (800) 794-6900
Fax: (510) 286-0693