This is a legal form that was released by the New Jersey Department of Labor & Workforce Development - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form WC-381?
A: Form WC-381 is a Medical Provider Application for Payment or Reimbursement of Medical Payment in New Jersey.
Q: Who can use Form WC-381?
A: Medical providers can use Form WC-381 to request payment or reimbursement for medical services provided in New Jersey.
Q: What is the purpose of Form WC-381?
A: The purpose of Form WC-381 is to request payment or reimbursement for medical services related to a workers' compensation claim in New Jersey.
Q: What information is required on Form WC-381?
A: Form WC-381 requires information such as the injured worker's name, date of injury, diagnosis, treatments provided, and the amount requested for payment or reimbursement.
Q: How do I submit Form WC-381?
A: Form WC-381 should be submitted to the workers' compensation insurance carrier or third-party administrator handling the claim.
Q: Is there a deadline for submitting Form WC-381?
A: Yes, Form WC-381 should be submitted within one year from the date of service or within one year from the date the medical provider becomes aware of the need for treatment.
Q: Can I submit multiple Form WC-381 for the same claim?
A: Yes, you can submit multiple Form WC-381 for different dates of service or multiple medical providers involved in the same claim.
Form Details:
Download a printable version of Form WC-381 by clicking the link below or browse more documents and templates provided by the New Jersey Department of Labor & Workforce Development.