Workers' Compensation Provider Information

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Provider Bill Pay Process

The City of Mesa is both a self-insured and self-administered entity for workers’ compensation. If you are a provider of service for a City of Mesa workers’ compensation claimant, please forward the completed health insurance claim form (HCFA 1500/UB04) and medical notes* directly to the City of Mesa Workers’ Compensation office for processing:

City of Mesa Workers’ Compensation
P.O. Box 1466
Mesa, AZ 85211-1466

* Claims received without medical notes cannot be processed for payment.

Claim Status Requests

The City’s Workers’ Compensation office processes hundreds of payments every week. If you have not received payment and it has been more than 45 days since submission, please complete a Claim Status Request Form. The completed form can be emailed to or faxed to 480-644-5469. Your request will be processed as soon as possible and in the order in which it was received.