West Virginia Attending Physician Benefits Form is a document used by medical providers in the state of West Virginia to request reimbursement for services rendered to patients. It is used to document the services provided, the costs associated with those services, and the patient's insurance plan. There are two types of West Virginia Attending Physician Benefits Forms: the Provider Reimbursement Form and the Medicaid Reimbursement Form. The Provider Reimbursement Form is used to submit claims for services provided to patients who have private insurance or other forms of coverage. The Medicaid Reimbursement Form is used to submit claims for services provided to patients who are enrolled in the West Virginia Medicaid program. Both forms require the provider to include information about the patient, the service provided, the cost of the service, and the patient's insurance plan.