A provider who has submitted required bills and reports to an insurer and who disputes the amount or timeliness of a payment made by an insurer may ask the bureau to review the fee dispute. The provider or their attorney must file an Application for Fee Review, LIBC-507. Click here for instructions on completing this form.

A Medical Report Form, LIBC-9, is required to be submitted to the employer or insurer within 10 days of initial treatment of a work-related injury and monthly thereafter as long as treatment continues. This form must be accompanied by documentation to support the billing. Click here for instructions on completing this form.