- Complete DWC-1 First Report of Injury providing the details of the accident and injury.
- Complete DWC-1A Wage Statement providing wage history for the injured employee.
- If you are a drug free work place, post-accident drug testing must be completed in accordance with your drug free work place policy procedure.
- Contact a preferred urgent care facility by telephone prior to sending the injured worker. Inform the urgent care that you have an injured worker coming and that Benchmark Administrators is the claims administrator.
- Advise the injured worker they must return to your office or job site after receiving medical care and provide the doctor’s signed return to work slip or documentation of medical disability.
- Please forward the return to work/disability slip from the doctor to Benchmark Administrators as soon as possible.
- If a worker is seriously injured and needs immediate care or is transported by ambulance, the employer should have a co-worker or supervisor go with the injured worker to assist the injured worker with any insurance related information that the medical provider may require.
Florida
When an employee is injured on the job, proceed with the following:
Required State Forms
Florida - First Report of InjuryAdditional Forms
Medical Provider Options:
Concentra Urgent Care Centers
Advent Health Centra Care Centers
Correspondence & Prescription Billing
Benchmark Administrators
PO Box 46350
Las Vegas, NV 89114
Telephone: (321) 594-7222
Toll Free: (800) 362-5198
Fax: (352) 240-1203
Medical Billing
Medical Bills Can Be Mailed To:
P.O. Box 14365
Lexington, KY 40512
Process medical bills online by signing up with E-Billing Benefits
Western Integrated Care, on behalf of Benchmark Administrators, Payer ID is LV191.
24-HOUR CLAIM REPORTING HOTLINE: 1-866-337-0891
Customer Service Representatives are on call 24 hours per day to assist you. Please have the injured worker's information available as well as the accident description.