Request for Decision on Unpaid Medical Bill(s) (Form HP-1.0)
For a Request for Decision on Unpaid Medical Bills (Form HP-1.0) to be processed, it must be first matched with a claim within the system.
To begin, enter the WCB Case Number or the Claim Administrator Claim Number.
Next, enter the information for two of the following four fields:
- Date of Injury
- Last Four of Social Security number
- Date of Birth
- Patient Last Name
Then select Search for Claim.
When a claim is matched to the search information, search results will be displayed, and you may continue with your request.
If a claim is not matched, check the criteria you entered or enter new search criteria and search again.
If there is still no match, you will not be able to submit Form HP-1.0 until a claim can be matched.