Q: Is there a time frame within which denied items must be resolved?
A: From L&I’s perspective, L&I denied billing items become final after 60 days unless you file an appeal. Items will remain in Denied state in Gardiant Works until you either resubmit them or write them off, or until L&I reverses its decision and pays the item (possibly after a “paper adjustment” has been submitted outside of Gardiant Works).
***** REMITTANCE ADVICE LEGAL NOTICE *****
INITIAL PAYMENTS OR ADJUSTMENTS RESULTING IN INCREASED PAYMENTS MADE ON THIS
REMITTANCE ADVICE WILL BECOME FINAL SIXTY (60) DAYS AFTER RECEIPT UNLESS:
1)A WRITTEN REQUEST FOR RECONSIDERATION IS FILED WITH THE DEPARTMENT OF LABOR
AND INDUSTRIES, OLYMPIA, OR 2) A PROVIDER'S REQUEST FOR ADJUSTMENT FORM IS
FILED WITH THE DEPARTMENT OF LABOR AND INDUSTRIES, OLYMPIA, OR 3)AN APPEAL IS
FILED WITH THE BOARD OF INDUSTRIAL INSURANCE APPEALS, OLYMPIA, WITHIN THAT
TIME.
ADJUSTMENTS MADE TO PREVIOUS PAYMENTS ON THIS REMITTANCE ADVICE RESULTING IN
DECREASED PAYMENTS WILL BECOME FINAL TWENTY (20) DAYS AFTER RECEIPT UNLESS:
1)A WRITTEN REQUEST FOR RECONSIDERATION IS FILED WITH THE DEPARTMENT OF LABOR
AND INDUSTRIES, OLYMPIA, OR 2) A PROVIDER'S REQUEST FOR ADJUSTMENT FORM IS
FILED WITH THE DEPARTMENT OF LABOR AND INDUSTRIES, OLYMPIA, OR 3)AN APPEAL IS
FILED WITH THE BOARD OF INDUSTRIAL INSURANCE APPEALS, OLYMPIA, WITHIN THAT
TIME.
ADJUSTMENT REQUESTS MAY BE SENT ELECTRONICALLY OR BY MAIL TO THE DEPARTMENT
OF LABOR AND INDUSTRIES, PO BOX 44269, OLYMPIA, WA 98504-4269.
RECONSIDERATION REQUESTS MUST BE SENT TO THE DEPARTMENT OF LABOR AND
INDUSTRIES, PO BOX 44291, OLYMPIA, WA 98504-4291.
APPEALS MUST BE SENT TO THE BOARD OF INDUSTRIAL INSURANCE APPEALS, PO BOX
42401, OLYMPIA, WA 98504-2401 OR SUBMITTED ON AN ELECTRONIC FORM FOUND AT