Electronic Billing Authorization
See also
| Document Information | ||
|---|---|---|
 Get help downloading & printing files.  How to complete a fillable form. |
||
| Title |
Electronic Billing Authorization (A fillable form - 32 KB PDF)
|
|
| Description | To authorize L&I to accept electronically submitted bills for services provided to injured workers (2 pages). |
|
| Detail | ||
| Form number | F248-031-000 | |
| Availability | Online only. See document above to download. |
|
| Keywords | billing, bills, Direct Entry, provider | |
| Languages | English | |
| Valid dates | 12-2011 | |
| Contact information |
Fee Schedules
|
|
| Web pages | For Medical Providers | |
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