Get the free Ancillary Workers' Comp Referral Form

Our Ancillary Referral Form is a quick and easy way to submit a referral for ancillary products and services. Contact us for any questions or immediate service needs.

How to fill out ancillary workers comp referral

How to fill out ancillary workers comp referral

1. Begin by gathering all necessary information about the injured employee.
2. Identify the specific ancillary services required (e.g., physical therapy, chiropractic care).
3. Fill out the referral form accurately, including employee details, injury information, and requested services.
4. Specify the duration and frequency of the requested ancillary service.
5. Ensure that all required signatures and authorizations are obtained.
6. Submit the completed referral to the appropriate workers' compensation insurance provider or claims manager.
7. Keep a copy of the referral for your records.

Who needs ancillary workers comp referral?

1. Any employee who sustains a work-related injury that requires additional medical services beyond standard treatment may need an ancillary workers comp referral.
2. Employers or claims adjusters seeking to facilitate access to specialized care for injured employees also need to complete a referral.

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What is ancillary workers comp referral?

Ancillary workers comp referral refers to the process of directing injured employees to additional services or specialists beyond primary medical treatment to aid in their recovery and return to work.

Who is required to file ancillary workers comp referral?

Employers, insurance companies, or claims administrators are typically required to file ancillary workers comp referrals when an employee's injury requires specialized treatment or services.

How to fill out ancillary workers comp referral?

To fill out an ancillary workers comp referral, gather necessary information about the injured employee, details of the injury, and the specific services being referred. Complete the appropriate forms provided by the workers' compensation insurer or state regulatory body.

What is the purpose of ancillary workers comp referral?

The purpose of ancillary workers comp referral is to ensure that injured employees receive comprehensive care that addresses all aspects of their recovery, facilitating a quicker and more effective return to work.

What information must be reported on ancillary workers comp referral?

The information that must be reported includes the employee's personal and employment details, injury description, treatment needs, and the specific ancillary services being recommended.