What are the repercussions for the medical provider if the previous version of the C-4 or HCFA-1500 forms are submitted to the Board and/or the carrier after March 31, 2009?
Medical providers who do not use the new C-4 forms, on or after, April 1, 2009 will be penalized. If the medical provider fails to submit the correct Board prescribed form, the liable self-insured employer, insurance carrier, third-party administrator, Re-opened Case Fund, or the State Insurance Fund is not required to pay the medical provider for any examinations, services and/or treatments included in the documentation submitted. In addition, the Board will investigate why the doctor is not using the correct new form and if warranted issue an administrative warning or commence temporary suspension or revocation proceedings.
Related Questions
- What are the repercussions for the medical provider if the previous version of the C-4 or HCFA-1500 forms are submitted to the Board and/or the carrier after March 31, 2009?
- Do the various paper versions of the C-4 forms require an actual signature of the medical provider, and if so, does it have to be an original signature?
- Why do the new forms include the medical providers National Provider Identification number when the previous C-4 did not?
