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Washington Notice of Independent Medical Exam No-Show or Late Cancellation

Category:
Washington Workers Compensation - Official
State:
Washington
Control #:
WA-SKU-3749
Format:
PDF
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Description

Notice of Independent Medical Exam No-Show or Late Cancellation The Washington Notice of Independent Medical Exam No-Show or Late Cancellation is a form required by Washington State law when a patient fails to appear or cancels an Independent Medical Exam (IME) less than 24 hours before the scheduled appointment time. The notice is used to document the patient’s failure to comply with the regulations related to IME appointments. There are two types of Washington Notice of IME No-Show or Late Cancellation: one for no-shows and one for late cancellations. The no-show notice is used when a patient fails to appear for an IME at the scheduled time, and the late cancellation notice is used when the patient cancels the appointment less than 24 hours in advance. Both notices must include the patient’s name, date of the scheduled exam, and the date of the no-show or late cancellation. The notices must be signed by the patient and returned to the provider within 30 days of the no-show or late cancellation. Failure to return the notice may result in the patient being responsible for the costs associated with the no-show or late cancellation.

The Washington Notice of Independent Medical Exam No-Show or Late Cancellation is a form required by Washington State law when a patient fails to appear or cancels an Independent Medical Exam (IME) less than 24 hours before the scheduled appointment time. The notice is used to document the patient’s failure to comply with the regulations related to IME appointments. There are two types of Washington Notice of IME No-Show or Late Cancellation: one for no-shows and one for late cancellations. The no-show notice is used when a patient fails to appear for an IME at the scheduled time, and the late cancellation notice is used when the patient cancels the appointment less than 24 hours in advance. Both notices must include the patient’s name, date of the scheduled exam, and the date of the no-show or late cancellation. The notices must be signed by the patient and returned to the provider within 30 days of the no-show or late cancellation. Failure to return the notice may result in the patient being responsible for the costs associated with the no-show or late cancellation.

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