<h3>Getting Started...</h3>
<p style="font-size: 13px;">We will need either the <a href="http://demo.likeconception.com/like/workers-compensation-claim-forms/">WC Claim Form</a>, <a href="http://demo.likeconception.com/like/liability-intake-form/">Liability Intake form</a>, or <a href="http://manleyandassociates.velinajewelry.com/case-management-referral-form/">Case Management Referral Form.</a> For all Medicare Set-Aside (MSA) and Medical Cost Projection (MCP) referrals, we also need the following:</p>

<ul>
 	<li style="font-size: 13px;">Initial treatment report and first report of injury</li>
 	<li style="font-size: 13px;">Operative notes from procedures conducted prior to the last three years</li>
 	<li style="font-size: 13px;">Last three years medical records: We do not need physical therapy notes,lab reports, or nurses' progress notes from hospitalizations. We do need physician office visit notes, operative notes, hospitalization discharge summaries.</li>
 	<li style="font-size: 13px;">Last two years pharmacy summary: This printout should include drug names, dosages, quantities, and fill dates.</li>
 	<li style="font-size: 13px;">Last two years claims payment history: This should include both indemnity and medical payments. (If the referral is for a liability claim, we do not expect to receive a payment history.)</li>
</ul>
<p style="font-size: 13px;">If you need the injured individual's Medicare status, the signed <a href="http://manleyandassociates.velinajewelry.com/wp-content/uploads/2017/01/SSA-release.pdf">SSA Release</a> is required. If you need the MSA submitted to CMS, the signed <a href="http://manleyandassociates.velinajewelry.com/wp-content/uploads/2017/01/Consent2017.doc">Consent Form</a> is required. Should you need to discuss the claim prior to making a referral, please do not hesitate to <a href="http://manleyandassociates.velinajewelry.com/contact/">contact us.</a></p>