Please follow the Enrollment Instructions below to become an electronic submitter for Washington State Department of Labor & Industries (LNI).

Please Note: This connection is currently only available for our SolAce Basic users. If you do not use our software to create your claims (837's) we cannot offer this connection at this time.

Instructions on Enrollment

In order to submit and/or receive directly with LNI through Provider Express Billing (PEB), you must first do the following:

•  Ensure you have your LNI Provider Account Number

•  Complete and submit the Electronic Billing Authorization Form

•  Register with SecureAccess Washington (SAW) here: https://secure.lni.wa.gov/home/

•  Request set up for 835 if electronic remits if desired

•  Make sure your provider account is authorized for EDI Submission and remittance advice retrieval

•  If not sure how, please call the EDI Unit at 360-902-6511. Let them know you will be uploading files and need to submit test claims

Once you have your Provider Account number, User ID, and Password for their PEB site and are completely set up to upload test files please call your SolAce Support Team at 602-439-2525 option 1.

If you have any questions regarding enrollment for electronic billing with LNI please call their EDI Department at 360-902-6511.

When speaking with them let them know you will be uploading files through their PEB site and are using our software to create your claims (837's)

We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.
 

Electronic Billing Authorization Form

Provider Information

•  Enter your L&I Provider Account number and NPI

•  Enter your Provider/Group or Facility Name

•  Enter the demographic information for your office

•  Enter the name, phone, and email address of the main Contact Person for your office

Clearinghouse Information

• Skip this section

Signature section

•  Type Provider Name.

•  Enter Signature and Date of signing authority

•  Print Name of signing authority
   

Submitting your Forms

It is recommended that you keep a copy of all the forms you will be submitting for your records. Send the completed enrollment forms to:

    Department of Labor and Industries
    Electronic Billing Unit
    PO Box 44263
    Olympia WA 98504-4263
    Fax (360) 902-6192

It is very important that you complete and fax the entire application as described above. Incomplete applications will not be processed and will be returned to the submitter.

Set up and Testing

Once you have submitted the form and completed registration on their site please call the SolAce Support Team at 602-439-2525 option 1. We will help you with mailbox set up and test transmission.