Get Employer Forms - Doctors Care

Filling out the Employer Forms - Doctors Care online is essential for ensuring that services are rendered efficiently and accurately. This guide provides a comprehensive walkthrough of each section of the form, allowing users to complete it with confidence.

Follow the steps to complete the Employer Forms - Doctors Care online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the date. This is the date on which the form is filled out, ensuring that it is current and relevant.
3. Fill in the patient's name in the designated field. This will help identify the individual receiving services.
4. Complete the company details, including the company name and contact information such as phone and fax numbers.
5. Provide the company's address. This should include street address, city, state, and ZIP code to ensure accurate communication.
6. Identify the primary contact person within the company. Enter their name and contact details to facilitate further correspondence.
7. Input the BT account number, if applicable, to link the services to the correct business account.
8. Check all the required services that apply by selecting the appropriate options, such as physical examinations, drug screenings, and any special examinations needed.
9. If the service involves a worker's compensation injury treatment, indicate the date of the injury and specify the type of injury.
10. Complete the agency details if a Department of Transportation (DOT) drug screening is required and check the respective agency.
11. Fill in the non-DOT test codes if applicable. This may include panels such as 5 Panel, 9 Panel, etc.
12. If required, indicate any special examinations needed, such as audiograms or chest X-rays, by checking the relevant boxes.
13. For worker's compensation claims, confirm if the employer has filled out the First Report of Injury. Select 'Yes' or 'No' and provide a copy if available.
14. Specify where claims will be filed, whether with the employer or a workers' compensation carrier, providing their contact information.
15. Optionally, input billing company information, such as the company name, phone, policy number, and address if applicable.
16. Certify that the information provided is correct by signing and dating the form. Include the printed name and position title of the signatory.
17. For internal use only: the person who completed the form should enter their initials, the center name, and the date when the form was completed.
18. Finally, review the completed form for any errors or omissions before saving changes, downloading, printing, or sharing the form as needed.

Complete your Employer Forms - Doctors Care online today to ensure prompt and accurate processing.