Refer a Case

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Refer A Case

Coventry Workers’ Comp Services makes the referral process easy by giving you three ways to contact us: telephone, e-mail, or fax. We value your time, so we have designed each of these methods to be as brief and efficient as possible.  Information submitted through the online from will be encrypted using SSL technology.

Refer Online

Refer by Phone

Refer by Fax

Online Case Referral

*Required Fields

*What service does this referral relate to? Select A Service Field Case Management Independent Medical Examination Telephonic Case Management Utilization Review Medicare Set-Aside Other Submit

Refer by Phone:  1.866.445.7286

Please call 888.987.2667 for MSA referrals.  For all other referrals, please call 1.866.445.7286

Refer by Fax:

Click Here for our MSA Fax Referral Form and send to 866.637.0470

Click Here for all other Referral Forms and send to 888.685.9375