What are C4 Forms?
Navigate to “Charges” screen by following the workflow. Here, select an appointment to Add/Edit the charges.
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Next, open a charge. In order to access the WCB or No Fault forms, when the Plan Balance is $0, hover your mouse pointer over the Claim drop-down from the top and select the desired option.
The Claim drop-down contains the following options:
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A tab “WCB Forms” opens. On the top of the screen, you can see the following C4 Forms buttons:
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C4 Forms
When you click on any of the form, it opens up in a new screen. You can Print these forms on given templates and Save them.
The Date of Examination on the C4 Form is auto-populated from Start Date of Service field on the Charge.
Follow the workflow then create a C4 form and then go to Exam Information. WCB Carrier Code entered via ‘Plan’ or ‘Patient Insurance’ auto-populates in the ‘Carrier Code #’ field.
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C4.3:
Practice Provider uses C4.3 Form to document, if patient has reached Maximum Medical Improvement and has Permanent Disability.
In the C-4.3 forms, user can add 12 characters in the Impairment Table field.
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In CureMD application, the C4.3 form has been updated to the latest version released by NY Worker Compensation Board.
Practice user can click on “Add details for another affected Body Part/Measurement” icon to add details for 5 affected body parts.
Once done, click on ‘Save & Print’ button to open up C4.3 Form in Crystal Report.