Workers' Compensation DME Referral Form
Optimize your workers' compensation Durable Medical Equipment (DME) referral process with our comprehensive and easy-to-use form. Designed specifically for healthcare providers and medical supply companies, this form streamlines the authorization and delivery of essential medical equipment for injured workers.
Why Use Our Workers' Compensation DME Form?
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Simplified Documentation: Capture all necessary patient, injury, and insurance details in one place.
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Accurate Claims Processing: Ensure all workers' compensation claim information is clearly documented to avoid delays.
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Comprehensive Equipment Options: Easily specify the required DME, including wheelchairs, walkers, hospital beds, and more.
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Efficient Delivery Instructions: Choose between shipping to the patient or pick-up at the provider location with preferred delivery dates.
How to Use This Form
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Fill out patient information, including contact details and injury specifics.
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Provide workers' compensation claim details such as claim number and insurance carrier.
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Enter prescribing physician information for authorization.
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Select the required DME supplies from the checklist.
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Specify delivery preferences and authorize the request with a signature.
Streamline your workers' compensation medical equipment referrals today with this user-friendly form, designed to reduce paperwork and speed up patient care.
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Workers’ Compensation Medical Supplies & Equipment
When workplace injuries happen, fast access to the right medical equipment is essential for recovery and return-to-work success. At WONACE Medical Supply, we provide reliable workers’ compensation medical supplies, mobility equipment, and rehabilitation solutions with efficient insurance coordination and delivery.
We support injured employees, case managers, adjusters, employers, and healthcare providers with high-quality equipment and streamlined service designed to reduce delays and improve outcomes.
Complete Medical Equipment for Work-Related Injuries
We provide a full range of medically necessary supplies and equipment for injury recovery, rehabilitation, and long-term care, including:
Custom powered wheelchairs and mobility scooters, Manual wheelchairs and walking aids, Orthopedic and rehabilitation equipment, Hospital beds and home care equipment,, Bracing, positioning, and support devices, Wound care and recovery supplies, Adaptive and complex rehab equipment, In-home safety and accessibility solutions, Every product is selected to support healing, restore independence, and improve quality of life after workplace injury.
Insurance Billing & Workers’ Comp Coordination
Our experienced team works directly with workers’ compensation carriers, case managers, and healthcare providers to simplify approvals and speed up equipment delivery.
We assist with: Documentation and authorization support, Claims coordination, Equipment recommendations based on clinical needs, Ongoing supply fulfillment, Fast processing to avoid treatment delays. We coordinate with major insurance providers, including Blue Cross Blue Shield and other approved workers’ compensation networks.
Fast Delivery & Local Support
We provide dependable service throughout Texas and nationwide, with convenient delivery and setup options. Our goal is to ensure injured workers receive the equipment they need quickly, safely, and with minimal disruption to recovery.
Why Choose WONACE for Workers’ Compensation?
Insurance billing expertise, High-quality medical equipment, Fast approvals and delivery, Personalized service for patients and case managers, Complex rehab and mobility specialists, Trusted provider for injury recovery care
Request Workers’ Comp Equipment Today
Need medical equipment for a workplace injury? Our team is ready to help coordinate approvals and deliver the right solution quickly.
Contact us today to get started with workers’ compensation medical supplies and recovery equipment.