Please Note: All versions of the C-4 medical billing forms (except the C-4.3) were replaced by the required submission of the CMS-1500 form on July 1, 2022. Learn more about the CMS-1500 Initiative.

To apply for a user ID and password to submit medical forms via the Board's website follow the steps outlined below:

• Read Overview/Features.
• Verify that your computer satisfies the Minimum Technical Requirements.
• Registrations will be processed in the order in which they were received.
• Upon receipt the registration will be reviewed and if approved, a user ID will be sent via email to the address given on the registration.
• The password will be sent via United States Postal Service to the Board authorized health care provider.

If you have questions regarding completing the registration, you may contact the WCB Online Services Technical Support Unit. Be sure to indicate to the WCB Online Services Technical Support Unit that you would like help in applying to submit health care provider medical forms via the Board's website.

If the Board's support unit has any questions regarding your registration, you will be contacted.