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What Board forms are to be utilized by medical providers to report treatment rendered within the Guidelines?

April 26, 2017forms guidelines medical rendered report treatment utilized

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What Board forms are to be utilized by medical providers to report treatment rendered within the Guidelines?

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The C-4 family of forms should be used to report all treatment rendered by physicians, chiropractors and podiatrists. Special Medical Treatment Guidelines forms are only utilized if the medical provider is requesting a variance or optional prior approval.