Please start by filling out your information. Depending on your position, the form will auto fill in the information to the right, so you won’t have to duplicate details. By submitting the form below, your claimant’s case information will be used by our experienced workers’ compensation staff to outline a thorough, itemized cost projection for non-urgent surgical procedures.

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Your Information

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Claimant

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Procedure

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File Upload
Maximum upload size: 15MB

Next Steps
CompAlliance will contact your indicated provider and available facilities to determine next steps.

The results of the projection service will be delivered to aid in setting reserves by forecasting charges for the expected procedure. Estimated allowances will be provided for current bill review clients.

Surgical Cost Projections are all individually processed by our team of experienced workers' compensation staff and normally available in 5-10 business days. For more information contact us at SCP@CompAlliance.com.

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Adjuster
Provider
Provider Secondary Contact (if applicable)
Case Manager

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