State Form 18487 Application for Adjustment of Claim for Provider Fee - Indiana

State Form 18487 Application for Adjustment of Claim for Provider Fee - Indiana

What Is State Form 18487?

This is a legal form that was released by the Indiana Workers' Compensation Board - a government authority operating within Indiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is State Form 18487?
A: State Form 18487 is an application for the adjustment of claim for provider fee in Indiana.

Q: What is the purpose of State Form 18487?
A: The purpose of State Form 18487 is to request an adjustment of claim for provider fee.

Q: Who can use State Form 18487?
A: State Form 18487 can be used by providers in Indiana who need to request an adjustment of claim for provider fee.

Q: What information is required on State Form 18487?
A: State Form 18487 requires information such as the provider's name, contact information, claim details, and reasons for requesting the adjustment.

Q: Are there any fees associated with filing State Form 18487?
A: The application itself does not mention any fees. However, it's always a good idea to check with the relevant department or agency for any potential fees.

Q: How long does it take to process State Form 18487?
A: The processing time for State Form 18487 may vary. It is recommended to contact the relevant department or agency for an estimate.

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Form Details:

  • Released on January 1, 2015;
  • The latest edition provided by the Indiana Workers' Compensation Board;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of State Form 18487 by clicking the link below or browse more documents and templates provided by the Indiana Workers' Compensation Board.

Download State Form 18487 Application for Adjustment of Claim for Provider Fee - Indiana

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