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Form 133A Complaint Against Utilization Review Agent - Massachusetts
What Is Form 133A?
This is a legal form that was released by the Massachusetts Department of Industrial Accidents - a government authority operating within Massachusetts. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 133A?
A: Form 133A is a Complaint Against Utilization Review Agent.
Q: Who can file Form 133A?
A: Any individual who is dissatisfied with the actions of a Utilization Review Agent in Massachusetts can file Form 133A.
Q: What is a Utilization Review Agent?
A: A Utilization Review Agent is an entity that reviews medical services to determine their medical necessity and appropriateness.
Q: What information is required on Form 133A?
A: Form 133A requires information such as the complainant's name, address, and details of the complaint against the Utilization Review Agent.
Form Details:
- Released on July 1, 2019;
- The latest edition provided by the Massachusetts Department of Industrial Accidents;
- 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 133A by clicking the link below or browse more documents and templates provided by the Massachusetts Department of Industrial Accidents.
Download Form 133A Complaint Against Utilization Review Agent - Massachusetts
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