Get the free EMPLOYEES CHOICE OF PHYSICIAN

Tennessee Bureau of Workers Compensation 220 French Landing Drive I-B Nashville TN 37243-1002 FORM C-42 EMPLOYEE S CHOICE OF PHYSICIAN An employer must provide a partially-completed form listing at least three physicians to an employee upon the report of a workplace injury. TO BE COMPLETED BY THE EMPLOYER Employer Date of Injury Employer Contact Phone Email Physician Name Phone Address City State Zip I have selected the following physician from the list provided to me by my employer Employee...

How to fill out employees choice of physician

How to fill out employees choice of physician

1. Step 1: Obtain the employees choice of physician form
2. Step 2: Gather the necessary information from the employee
3. Step 3: Review the form for completeness and accuracy
4. Step 4: Verify the employee's choice of physician with the designated healthcare provider
5. Step 5: Submit the completed form to the appropriate department for processing
6. Step 6: Keep a copy of the form for record-keeping purposes

Who needs employees choice of physician?

1. Employees who want to have a say in their choice of physician
2. Employers who provide employee healthcare benefits
3. Human resources departments responsible for managing employee benefits
4. Third-party administrators or insurance carriers handling healthcare claims

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What is employees choice of physician?

Employees choice of physician refers to the ability of employees to choose their own doctor or healthcare provider for work-related injuries or illnesses.

Who is required to file employees choice of physician?

Employers are required to file employees choice of physician when an employee requests to see a specific doctor for a work-related injury or illness.

How to fill out employees choice of physician?

Employers must provide the necessary form to the employee and ensure that all required information is accurately filled out, including the employee's choice of physician.

What is the purpose of employees choice of physician?

The purpose of employees choice of physician is to ensure that employees receive medical care from a provider they trust and feel comfortable with for work-related injuries or illnesses.

What information must be reported on employees choice of physician?

The information that must be reported on employees choice of physician includes the name and contact information of the chosen physician, as well as the reason for the choice.