Any physician providing a consultation to a patient involved in a motor vehicle accident can fill out the Specialized Physician Services Report A94573. In order to provide a consultation, you require a written referral from a physician.
- The intent of the Specialized Physician Services Report is to provide assistance in maximizing recovery and progress towards functional restoration for patients who have an active claim under ICBC’s new Enhanced Care Insurance System.
- The Report allows for additional information sharing between the physician and ICBC, specifically information that would not normally be included in a typical consultation letter completed by a physician providing specialized services.
- This information is important for ICBC to help determine care supports and other funding decisions to support patients.
The ICBC Specialized Physician Services Report template can be found
Complete the report following an initial consultation with the patient who has been in a motor vehicle accident, or when the report has been requested by ICBC. In circumstances where more information (e.g., labs/imaging) is required, you may choose to complete the report after the results are available.
It is recommended that the report be delivered to ICBC no later than 30 business days from the date the consultation was completed in order to provide information that is clinically relevant to the care of the patient.