Reasonableness of Fees

Reasonableness of fee provisions can be found in §102.16 (2m), Wis. Stats., and are further detailed in Wis. Admin. Code § DWD 80.72.

The provider must file with the department within six (6) months from the date they first received notice from the insurer, or self-insured employer, refusing to pay the provider's bill. (Reasonableness of Fee Dispute Resolution Request Form WKC-9498)

Reasonableness of fee is in dispute (Guide Letter GL94):

NOTE: By law, when the provider files the dispute application with the department, the provider must, at the same time, send or deliver a copy of all materials submitted with the dispute application to the insurer or self-insured employer who is refusing to pay for the treatment it considers unnecessary.

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