MLC - Medical-Legal & Consulting Billing Form
Use this form for Medical-Legal & Consulting billing.
• There is a drop down for the type of service so you can enter multiple lines if necessary.
• If you have a type of service not listed, you can select “other” and type it in.
• There is an auto-adding total charge.
• Provider signatures are acceptable as TYPED or DIGITAL signatures if submitting by email.