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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{class="scroll_to"} 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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