Electronic Billing Authorization


Electronic Billing Authorization

Document Information
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Title	Electronic Billing Authorization (A fillable form - 154 KB PDF)
Description	To authorize L&I to accept electronically submitted bills for services provided to injured workers (3 pages).
Detail
Form number	F248-031-000
Availability	Online only
Keywords	authorization, billing, bills, electronic billing, provider
Languages	English
Valid dates	03-2009
Contact information	Fee Schedules
Web pages	For Medical Providers