Completing the form begins with the Interval box at the upper left. Under the rules of New York State, the very first Workers’ Compensation claim MUST be done using the C4.0 form. All claims submitted AFTER the first one MUST be on the C4.2. If subsequent claims are submitted on the C4.0 they are likely to be denied and rejected on this technicality.
When the New York Workers’ Compensation patient first arrives in the practice, verify that the black dot is in the 4.0 Initial Circle.
As soon as the Initial claim has been created, return to this window and move the selection to the 4.2 Progress Circle. If the change from 4.0 Initial to 4.2 Progress is NOT made before additional visits are entered, those additional visits will be submitted on the 4.0 Initial form.