What is MG-1 Form?

A request is sent in MG-1 Form, that a certain procedure or test based on a correct application of the Medical Treatment Guideline needs to be performed on patient. This request is sent by the health care provider for confirmation from the Insurance Carrier/Employer.
CureMD has updated WCB forms according to the latest version released by NY-WCB.
To view this form follow the workflow mentioned, click on the Claims button and then select Wokrer Compensation option from the drop-down menu.
Click on MG-1 add icon to view the updated form.

User can fill in all the required fields on this form to proceed.

However, user can check “Designated Contact Information not available” checkbox under Section C to disable the input field “A. Insurer’s designated fax # or email address as provided on the Board’s website” from populating on the MG-1 Report.

Furthermore, a checkbox “I certify that I am making the above request for authorization. This request was made to the insurer/self-insurer using the following means of same-day transmission (A or B)” is mandatory to Save and Save & Print form.
After certifying the terms and condition user can generate the updated MG1 form by clicking on Save or Save & Print button.

On the MG-1 form, NPI No. field is populated with the NPI of attending doctor from Settings. To configure settings to add NPI Number, click here.

To email, print or fax this report, user can utilize the icons placed on the top of the report.