Claimant Details Needed for Medical Bill Submission

Medical providers can ensure expeditious medical bill processing by submitting their bills with the following information about the injured worker:

  • First and last name
  • Home address
  • Phone number(s) (if known)
  • Social Security Number
  • Date of birth
  • Date of accident
  • Employer’s name
  • Employer’s policy number (if known)
  • NYSIF case number (if known)
  • Workers Compensation Board (WCB) case number (if known)

Information submitted by medical providers should include:

  • Tax ID number
  • Billing address
  • WCB rating code
  • WCB authorization number
  • Name of treating provider and treatment location address
  • Each date of service
  • The billing code such as the CPT code, HCPCS code (Durable Medical Equipment), NDC number (Prescription Drugs)

Medical bills must be accompanied by appropriate, legally required, medical reports. See the required treatment and diagnosis information that must be included on a submitted medical bill.

Effective December 1, 2015, please submit all medical provider bills to the following address, or submit your bill electronically:

P.O. Box 66699
Albany NY 12206

WCB forms available to medical providers: