Interpreter Invoice Form

Thank you for choosing to submit your Interpreter Invoice through the new and improved ProCare form. If you require additional assistance, call 866.941.7878 or email our form support team.

Interpreter Invoice Form

"*" indicates required fields

Interpreter Details

Date of Service*

ProCare's PO Number*

Claimant Name*

Appointment Status*

Interpreter's Name*

Certification Number*

Interpreter Starting Address*

*Required field. You must enter valid information for the fields required for your form to submit.
**For California Certified services, these fields are required.

Start Time*

End Time*

Interpretation Hours**

Interpretation Rate*

Mileage Units*

Mileage Rate*

Other Quantity

Other Rate

Other Description

One (1) hour min. is required for hours. Please fill out all fields, even if the value is zero.

Subtotal Amount ($)

Provider Information

Provider ID*

Provider Name

Provider Phone

Provider Email*

Additional Comments

Comments

Next Office Visit

Next Office Visit Date

Appointment Time

Facility Name

Facility Phone

Facility Address

Upload Files

File

Drop files here or

Max. file size: 32 MB.

Unique ID

Interpreter Invoice Form

Interpreter Invoice Form

Interpreter Invoice Form

Interpreter Details

Provider Information

Additional Comments

Next Office Visit

Upload Files

PROCARE, INC.

Tel: 866.941.7878

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Tel: 866.941.7878