New Service Requests

Proper processing of files begins with the completion and submission of the correct documents.

To ensure that the delivery of important case information is complete and accurate, Precision has provided forms for download and completion, available by expanding the menus below and clicking on the appropriate forms.

Please check back often for updates and do not hesitate to contact our attorneys with any questions that you may have at 888-961-LIEN.

Single Claimant Incident Authorization Forms

Click the type of service below to download and view the corresponding authorization documentation required to commence service.

In order for Precision to properly represent the claimant in the Medicare portion of their case, CMS requires that the following documents be completed and submitted in addition to Precision’s Intake Form:

If your firm has already reported the claimant’s case to the Medicare contractor and you would like for Precision to procure or dispute a Conditional Payment or Final Demand Amount, Precision will require the following documents:

In an effort to prepare the most accurate Medicare Set-Aside Allocation Proposal, Precision will require the following items to be submitted along with Precision’s standard Intake Form:

  • Precision Resolution New Case Intake From;
  • Records/Reports from Claimant’s Treating Physician(s) from the Past Two (2) Years;
  • IME Reports from the Past Three (3) Years; and
  • Bill of Particulars (If Applicable)
CMS requires that the following documents be completed and submitted in order to initiate representation.

Precision will require the following documents to be submitted along with the standard Precision Intake form:

In addition to Precision’s standard intake form, you will need to have your client execute and send the form below to the ERISA Plan Administrator so that Precision may analyze the plan documents.