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New Claim Reporting Number – Effective July 1, 2025

As part of our ongoing commitment to service, 24/7 workers’ compensation claim reporting remains available.
Please call our toll-free number: 1-800-362-5198 to report all new claims.

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Friendly and proactive services for workers’ compensation claims
File a Claim

Select a state:

Procedures, providers, and processes differ by state. Select the state on the map in which payroll is finalized, or choose from the drop-down below to see specific information.

Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Maryland, Michigan, Mississippi, Minnesota, Missouri, Montana, North Carolina, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia, Wisconsin

USL&H Claims

If you need to file a claim for a USL&H policy, please use the below forms:

USL&H Claim Kit

LS-202

LS-1

Temp Fill Form

Medical Billing

Medical bills should be mailed to:

P.O. Box 14365
Lexington, KY 40512

Process medical bills electronically through the following ebilling options:

Western Integrated Care (WIC), on behalf of BMA payer ID is LV191 via ebilling provider Data Dimensions or J4466 or J4005 via ebilling provider JOPARI.

If providers are interested in enrollment or have questions about submitting via Data Dimensions or Jopari Solutions, please reach out to the following support resources:

Data Dimensions: www.datadimensions.com/support

Jopari Solutions: www.jopari.com/ebill-enrollment or www.jopari.com/contact-us

General Inquiries

800-362-5198