To be considered a complete statement for services, providers must include charges on a proper billing form (CMS HCFA-1500 or UB-92) with medical records substantiating charges attached. Bills may be submitted to KEMI via electronic submission through our clearinghouse, WorkCompEDI, or by mail.
To submit a bill electronically, use the following payer ID:
- CQ834 “Kentucky Employers’ Mutual Insurance”
Mailed submissions may be sent to the following address:
- KEMI
P.O. Box 4208
Clinton, IA 52733-4208