Documents

Category: 
Name Description, Date, Category
PDF Document EPI Model Verification Statement
Verification statement that the diagnosis was not from a suspended physician
Nov 30, 2012
General Documents, EPI
PDF Document EPI Payment Percent Change 2011
Outlines the EPI payment percent reduction from 38 to 31 percent
Nov 01, 2011
General Documents, EPI
PDF Document EPI Payment Percent Change 2015
Outlines the EPI payment percent increase from 28 to 33 percent
Nov 02, 2015
General Documents, EPI
PDF Document EPI Suspended Physician Notice
EPI notice of suspended physicians whose diagnosis is not acceptable
Feb 28, 2011
General Documents, EPI
XLSX Document Keene Approved Job Sites List EXCEL
These sites have been established to have had Keene asbestos-containing products - EXCEL
Mar 02, 2015
General Documents, Keene
PDF Document Keene Approved Job Sites List PDF
These sites have been established to have had Keene asbestos-containing products - PDF
Mar 02, 2015
General Documents, Keene
PDF Document Keene Claim Filing Instructions
Instructions for filing an asbestos-related injury claim
Feb 28, 2011
General Documents, Keene
PDF Document Keene Claim Form
Use this form for claim submission via paper, email, or fax
Feb 28, 2011
General Documents, Keene
PDF Document Keene CRDP
Keene First Amended asbestos-related personal injury Claims Resolution and Distribution Procedures (CRDP)
Dec 27, 2013
General Documents, Keene
PDF Document Keene Disallowance/Deficiency Codes
A listing of Keene disallowance and deficiency codes and descriptions
Aug 18, 2014
General Documents, Keene
Results: 46 Records found.