When we can auto accept a claim, we can process it in 7 seconds. If there’s inaccurate or missing information, we’ll need to follow-up with you or your patient. For cover there must be an identifiable accident and injury. The accident must have caused the injury. When did it happen? Time & date. Where did it happen?

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As a registered provider, you can lodge claims on behalf of your patient if you think they have an injury we cover. You'll need to check you're lodging the right type of claim, and following the right process. It’s best to complete the forms with your patient during their first visit. On this page.

Sep 1, 2024 · Complete Immediately: ACC Student Accident Insurance Form – this digital form must be completed by a faculty member on behalf of an injured student to verify coverage.

Please complete the claim form and submit it at My.WashingtonNational.com. You may also fax or mail in your form along with any other claim documents, using the contact information below.

• The ACC45 or ACC42 form can be lodged electronically or manually. • Please email, fax or post the ACC2152 form and clinical notes to: ACC Treatment Injury Centre, PO Box 430, Dunedin 9054, Fax (04) 560 5361, email [email protected] • Send your invoice to your ACC Service Centre (check www.acc.co.nz for contact and invoicing details)

This document outlines how to use our new ‘web served’ ACC claim form that integrates to My Practice. We’ll continue to develop the form to make it easier for you to lodge claims and reduce requests

Accident Compensation Corporation ACC – How to Begin Treatment Provider Registration with ACC Step 1: Fill out the ACC Application for Health Provider Registration (ACC 23) supplied by NZASA Step 2: Choose the form of payment • generally half hourly when acupuncture is given as a secondary modality • generally hourly for main modality

If yes, please complete the accident form (CLM-FORM-ACC) available at WashingtonNational.com or by contacting (800) 541-2254. WHERE TO SUBMIT CLAIMS: Mail: Washington National Claims Department, P.O. Box 2024, Carmel, IN 46082-2024

For an accident claim, the primary physician must complete the form, providing the diagnosis, how the condition originated, and the dates of treatment. If treated as an outpatient we need the service date.