Physicians and nurse practitioners bill WorkSafeNB on this one-page account for consultations and procedures on an injured worker's claim. Each line gives the date, time, place attended, description, service code and fee, and boxes tie the bill to an attached Form 8, Form 10 or other report. Major surgery and its anaesthesia are billed on WorkSafeNB's separate surgery and anaesthesia forms.
The physician or nurse practitioner completes and signs the whole account, declaring the services were rendered by them and not already paid. They add the claim and Medicare numbers, diagnosis, part of body, payee number and, where needed, the authorization number.
Download the current version from the source each time; forms change without notice.
Doctor's Account for Consultations and Procedures
Compte du médecin pour consultations et actes médicaux
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.
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Three months. The Doctor's Account notes that, under the Act, an application for payment must be made within three months of the service rendered. Reports run on a shorter clock: WorkSafeNB says physician, nurse practitioner and chiropractor reports are due within 72 hours of the injured worker's appointment.
No. The form has a box for services authorized as expedited and states that the reporting bonus does not apply to them. For other services, if one account spans several dates, WorkSafeNB uses the earlier date of service to calculate the reporting bonus.
Not major surgery. The form asks physicians to submit invoices for major surgery and the related anaesthesia on their own forms: the Surgery Billing Form and the Anaesthesia Billing Form for WorkSafeNB Claimants. Use the Doctor's Account for consultations and procedures, with pre-authorization for elective ones.