In the last section of the C-4 and C-4.2 forms, what it meant by the statement, “I actively supervised the health care provider named below who provided these services”?
Under the active and personal supervision of a licensed and Board authorized physician, medical care may be rendered, by a person employed by the physician, within the scope of such person’s specialized training and qualifications. (ie; a nurse practitioner, physician’s assistant, laboratory or diagnostic technician, physical or occupational therapist). In the event this occurs, the person rendering care should be named on the C-4 form(s) and the Board authorized physician must sign the form. • We began treating an injured worker prior to the Board’s release of the new C-4 forms, and we continue to provide treatment. Should we continue to submit the previous C-4 form or begin using the new C-4.2 form for continuous treatment? Going forward, health care providers should begin using the new C-4 series of forms. • The first line on the C-4.2 progress report asks for the date(s) of examination. There is only space for one date. How is this to be completed if there are multiple examination
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- In the last section of the C-4 and C-4.2 forms, what it meant by the statement, "I actively supervised the health care provider named below who provided these services"?
- May a health care provider modify the Department’s Notice of Intent to File an Appeal forms?
