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Form WCB-190 Petition for Payment of Medical and Related Services - Maine
What Is Form WCB-190?
This is a legal form that was released by the Maine Workers' Compensation Board - a government authority operating within Maine. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form WCB-190?
A: Form WCB-190 is the Petition for Payment of Medical and Related Services in Maine.
Q: What is the purpose of Form WCB-190?
A: Form WCB-190 is used to request payment for medical and related services in Maine.
Q: Who can use Form WCB-190?
A: Anyone who has provided medical or related services and wants to request payment in Maine can use Form WCB-190.
Q: Do I need to submit any supporting documents with Form WCB-190?
A: Yes, you need to attach all relevant bills, reports, and other supporting documents to your Form WCB-190.
Q: What is the deadline to submit Form WCB-190?
A: The completed Form WCB-190 must be filed within 90 days of the service date.
Q: What happens after I submit Form WCB-190?
A: After you submit Form WCB-190, the Maine Workers' Compensation Board will review your petition and make a decision on the payment.
Q: Can I appeal if my petition is denied?
A: Yes, if your petition is denied, you have the right to appeal the decision within 30 days of the denial.
Q: Is there a fee for filing Form WCB-190?
A: No, there is no fee for filing Form WCB-190.
Form Details:
- Released on October 1, 2015;
- The latest edition provided by the Maine Workers' Compensation Board;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form WCB-190 by clicking the link below or browse more documents and templates provided by the Maine Workers' Compensation Board.
