Service Invoice {BWC-1124} | Pdf Fpdf Docx | Ohio

 Ohio   Workers Comp   Injured Workers 
Service Invoice {BWC-1124} | Pdf Fpdf Docx | Ohio

Last updated: 1/29/2025

Service Invoice {BWC-1124}

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Description

BWC-1124 / C -19 - SERVICE INVOICE. This form is used for billing services provided to an injured worker under a workers' compensation claim. It collects detailed information about the type of service, provider details, and charges for the service rendered. This form is used by service providers such as dental, nursing, practitioner, vocational rehabilitation, or other vendors to request payment for services provided to an injured worker. The form must be submitted to the appropriate party, either BWC or the managed care organization, along with any required documentation for processing reimbursement. www.FormsWorkflow.com

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