Intellect™
SAMPLE - BILLING WORKER STATEMENTS
Batch and Group of Patients
Scroll through the samples, OR click on a specific option to go directly to its' sample:
1 (Standard Workers Comp Statement)
In keeping with the 2010 change from WCAB case numbers to ADJ case numbers, effective version 15.01.09, the labels on options 1, 2, and 3 of the Worker’s Comp statements have been changed to ADJ #1, ADJ #2, and ADJ #3, as indicated on Option 1 below.
Option 1 - Standard Worker's Comp Statement
WC FORM1 – Effective version 13.08.20
WC FORM2 – Effective version 13.08.20
PI FORM1 – Effective version 13.08.20
PI FORM2 – Effective version 13.08.20
