Document qd8XZz8JQVn1m4oK9gENvN54k

We regret to inform you that your bill as submitted cannot now be approved in full for the reason checked below* It is possible that you have failed to explain all the details in con nection with the case. If so, the approval is subject to revi sion. The fee schedule (and rules governing the same) is used as, a guide in approving bills. It is the Commission's desire to pay a fair average fee in all compensable claims. (DISREGARD ALL ITEMS NOT CHECKED.) Q First aid charge in excess of schedule rate. 0 Charge for office, house or hospital calls in excess of schedule rate. 0 Bill approved on flat rate basis. (See schedule.) 0 Special fees in eye injuries are paid only to physicians who limit their practice to eye,.ear, nose and throat work. You do not state on your bill that your practice is so limited. X-ray print (or film) and interpretation is not ^ on file. (See Rules on X-ray.) 0 Hospital bill approved at contract rate. 0 The proof, including your report, is not complete enough to justify the approval of fees for such frequent attention as shown on your bill. ' Bill submitted $.................................... Approved for payment $ ^our bill is approved except for X-ray for which we should have nrints . MED. 5~5M--4-33. ^lease send them when we Very truly yours, THE INDUSTRIAL COMMISSION OF OHIO, will consider nayment. NOTE:' A copy of the fee schedule will be mailed on request. IN REPLYING, ALWAYS GIVE CLAIM NUMBER.