Wcb audio billing form 2026

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The document outlines the requirements for creating or maintaining a WCB billing number for physicians and clinics in Alberta. It includes necessary information such as legal name, physician details, contact information, and signatures required for submission. The document also provides contact details for further assistance and instructions for faxing or mailing the application.

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Click ‘Get Form’ to open the WCB audio billing form in the editor.
Begin by entering the 'Legal Name of Company' and 'Physician's Name' in the designated fields. Ensure accuracy for prompt payment processing.
Fill in the 'Physician's Skill' and 'Speciality' sections, followed by your Alberta Health Practitioner I.D Number and CPSA ID Number.
Indicate the 'Start Date' using the format (Year / Month / Day) and provide your current WCB Billing Number.
Select whether the cheque should be made payable to 'Physician', 'Clinic', or 'Other'. If you choose 'Other', specify accordingly.
Complete the address fields for correspondence and cheque mailing, including city/town, postal code, province, telephone number, fax number, and email address.
Finally, ensure both the Physician's Signature and Clinic Administrator Signature are added along with their respective dates before submitting.

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