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Accreditation Request – Mental Health Primary Level Services

Type:
Downloadable forms
Last updated:
March 9, 2022
User:
Care providers

Use this form to request accreditation from the WCB to provide mental health primary level services to injured workers.

Download

application/pdf — 147.32 KB

Accreditation Request – Primary Level Services

Type:
Downloadable forms
Last updated:
March 10, 2022
User:
Care providers

Use this form to request accreditation for a care provider joining your assessment team.

Download

application/pdf — 148.12 KB

Accreditation Request – To add assessment team member

Type:
Downloadable forms
Last updated:
November 16, 2021
User:
Care providers

Use this form to request accreditation for a care provider joining your assessment team.

Download

application/pdf — 137.74 KB

Accreditation Request – To add treatment team member

Type:
Downloadable forms
Last updated:
November 16, 2021
User:
Care providers

Use this form to request accreditation for a care provider joining your treatment team.

Download

application/pdf — 143.71 KB

Accreditation Standards and Service Provider Guidelines for Registered Nurses (Nurse Practitioners) (RN(NP)s)

Type:
Publications
Last updated:
September 1, 2022
User:
Care providers

Read the accreditation standards and service provider guidelines for nurse practitioners treating WCB customers.

Download

application/pdf — 172.15 KB

Assessment Team Review

Type:
Fact sheets
Last updated:
October 25, 2020
User:
Care providers

Read when a care provider can ask for an assessment team review.

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application/pdf — 62.64 KB

Audiology’s Billing (AUD)

Type:
Downloadable forms, Online submission forms
Last updated:
October 25, 2020
User:
Care providers

Use this form for billing the WCB for treating an injured worker.

Fill Out Online

Download

application/pdf — 921.69 KB

Billing adjustment example - physical therapists

Type:
Downloadable forms
Last updated:
November 17, 2020
User:
Care providers

View a sample of how to make an adjustment or addition to your invoices.

Download

application/pdf — 447.18 KB

Billing adjustment example – occupational therapists

Type:
Downloadable forms
Last updated:
November 17, 2020
User:
Care providers

View a sample of how to make an adjustment or addition to your invoices.

Download

application/pdf — 459.97 KB

Chiropractor's Initial Report and Physiotherapist’s Initial Report (CHI/PTP) User Manual

Type:
Downloadable forms, Publications
Last updated:
October 25, 2020
User:
Care providers

Learn how to fill out the Chiropractor's Initial Report (CHI) and the Physiotherapist’s Initial Report (PTI) using the CHI/PTP user manual.

Download

application/pdf — 125.83 KB

Chiropractors' Fee Schedule

Type:
Publications
Last updated:
November 22, 2021
User:
Care providers

Use these fee codes and fees to bill for primary level services provided to WCB customers by chiropractors.

Download

application/pdf — 207.78 KB

Chiropractor’s Billing Form (CHRO)

Type:
Online submission forms
Last updated:
October 25, 2020
User:
Care providers

Use this form for billing the WCB for treating an injured worker.

Fill Out Online

Download

application/pdf — 920.96 KB

Chiropractor’s Initial Report (CHI)

Type:
Online submission forms
Last updated:
October 25, 2020
User:
Care providers

Within three days of beginning treatment, you need to forward this form to the WCB detailing your initial findings.

Download

application/pdf — 1.45 MB

Chiropractor’s Progress/Discharge Report (CHP)

Type:
Downloadable forms, Online submission forms
Last updated:
January 28, 2022
User:
Care providers

This form should be completed after each block of six treatments unless the worker has been discharged, in which case, the CHP should be completed within seven days.

Download

application/pdf — 1.46 MB

Chiropractor’s Progress/Discharge Report (CHP) User Manual

Type:
Downloadable forms
Last updated:
December 14, 2020
User:
Care providers

Learn how to fill out the Chiropractor’s Progress/Discharge Report (CHP) as a chiropractor or physical therapist using the CHP user manual.

Download

application/pdf — 125.08 KB

Client health questionnaire

Type:
Downloadable forms
Last updated:
October 25, 2020
User:
Care providers

Use this questionnaire for the assessment team to get a complete picture of an injured worker’s health.

Download

application/pdf — 973.02 KB

Complex Case - Chiropractors

Type:
Fact sheets
Last updated:
November 23, 2021
User:
Care providers

A complex case is one in which the injuries will require more intensive and frequent management by the practitioner and will require more monitoring by the administrative staff at WCB.

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application/pdf — 72.5 KB

Dentist’s Initial Report (M7)

Type:
Downloadable forms
Last updated:
October 25, 2020
User:
Care providers

Use this form to provide information about treatment, functional recovery and response to treatment.

Download

application/pdf — 1.13 MB

Direct Deposit Application - Care providers

Type:
Downloadable forms
Last updated:
October 25, 2020
User:
Care providers

Use this form to apply to receive payment for your services by direct deposit.

Download

application/pdf — 116.41 KB

Direct Deposit Application: How to use Adobe Reader to fill your form

Type:
Downloadable forms, Fact sheets
Last updated:
October 25, 2020
User:
Care providers, Workers, Employers

Learn how to use Adobe Acrobat Reader to complete your direct deposit form.

Download

application/pdf — 797.27 KB