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Form C-4 AUTH Attending Doctor's Request for Authorization and Insurer's Response - New York
What Is Form C-4 AUTH?
This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form C-4 AUTH?
A: Form C-4 AUTH is a document used in New York for an attending doctor to request authorization and for the insurer to respond to the request.
Q: Who uses Form C-4 AUTH?
A: Attending doctors and insurers in New York use Form C-4 AUTH.
Q: What is the purpose of Form C-4 AUTH?
A: The purpose of Form C-4 AUTH is to request authorization for medical treatment or testing and for the insurer to provide a response to the request.
Q: What information is included in Form C-4 AUTH?
A: Form C-4 AUTH includes information about the patient, their medical condition, the requested treatment or testing, and the attending doctor's assessment.
Form Details:
- Released on July 1, 2018;
- The latest edition provided by the New York State 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 C-4 AUTH by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.
Download Form C-4 AUTH Attending Doctor's Request for Authorization and Insurer's Response - New York
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