Billing Forms and Completion Instructions

Reimbursement Manuals:

Health Care Providers

Hospitals

Ambulatory Surgical Centers

Need Assistance? Call our Customer Service line (850) 413-1613 or e-mail us.

	DWC-9 (CMS-1500) Form DWC-9 Instructions for Health Care Practitioners
	DWC-90(UB-04) DWC-90 Billing Instructions for Hospitals [Excel]
	DWC-90(UB-04) DWC-90 Instructions for ASC [Excel]
	DWC-11 for Dentists DWC-11 Instructions for Dentists
	DWC-10 for Pharmacy & DME Billing Instructions for DWC-10
	DWC-9 (CMS-1500) Billing Instructions for Work Hardening & Pain Management