The paper version of the C-4 form(s) must be signed by the authorized medical provider. The signature can be the original or a stamp or an electronic signature as long as the medical provider has the intent to sign the completed form. The provider must review and approve each completed form.
Also, someone else cannot sign the medical provider's name. €¢ Can self-employed physical and occupational therapists or free standing physical and occupational therapy practices request authorization for physical and occupational therapy, and if so, can they utilize the C-4AUTH form? A self-employed physical or occupational therapist (or free standing physical or occupational therapy practice) upon receipt of a prescription or referral from an authorized physician may render care and can request authorization and re-authorization for physical and occupational therapy, in accordance with 12 NYCRR §325-1.4, and Part 8, Physical Medicine, Ground Rule 8 of the Official New York Workers' Compensation ... more.
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