Get C568

Filling out the C568 medical invoice form online is a straightforward process that ensures accurate billing for health services. This guide provides step-by-step instructions to help users complete the form effectively while ensuring compliance with all requirements.

Follow the steps to complete your C568 form online

1. Click the ‘Get Form’ button to obtain the C568 medical invoice and open it in your document editor.
2. Enter the WCB claim number in the designated field. If you do not have this number, you may obtain it by contacting the WCB Claims Contact Centre.
3. Complete the personal health number and enter the worker's last name and first name, followed by the mailing address, including the street, city/town, province, and postal code.
4. Fill in the date of birth and initial of the worker, then indicate the worker's gender using the options provided.
5. Input the telephone number of the worker and specify the part of the body and side of the body being treated.
6. Record the date of service using the specified format (Year/Month/Day), and add the health service code as per the Alberta Health and Wellness Schedule of Medical Benefits.
7. Provide the date of the accident and the date of referral, ensuring that all dates are accurately formatted.
8. Describe the nature of the injury along with the name of the referring physician.
9. Enter the diagnostic code corresponding to the patient's diagnosis, and include any necessary modifiers that identify the nature of the service provided.
10. Specify the skill code relevant to the service and indicate the facility type where the service was performed.
11. Fill in the calls and encounter fields based on the number of services performed.
12. List the fees submitted for each service and ensure the total amount billed is calculated correctly.
13. Provide the name and address where payment should be sent, along with the provider's reference number.
14. Finally, ensure you sign, print your name, and fill in the date before submitting the form.
15. Once all fields are completed, save changes, download the form for your records, print it out, or share it as necessary.

Complete your C568 medical invoice online to ensure timely processing of your billing.