Workers' Compensation
The Workers' Compensation Law assists individuals who are injured from work related accidents or occupational diseases. This law provides injured workers with medical coverage.
In order for us to treat you for an injury that occurred while you were working, you MUST HAVE reported the injury to your supervisor. Your supervisor would then have filled out an injury report. In addition, we will need all the billing information to submit a claim, which includes:
Our Workers' Compensation information sheet/consent form- The name of the Workers' Compensation Insurance carrier
- The address of the Workers' Compensation Insurance carrier
- A phone number for the Workers' Compensation Insurance carrier
- The policy number of the Workers' Compensation Insurance carrier
- The carrier case number if one has been assigned
If the employer chooses to self-pay the claim, we will need the following information:
- The employers name
- The employers address
- The employers phone number
- A contact name for the employer
