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- Health Care Services Forms
Select the link above and scroll down to Health Care Services Forms
- Professional Review Policy
- Publication of Injured Worker's Social Security Number on the EOB
- Provider's Report of Claim & Request for Medical Payment Form
- Copying Fee Charges by Health Care Providers under a Subpoena
- Health Care Services Rule Requirement to Reimburse Providers a 3% Late Fee for Payments That Exceed 30 Days