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Insurance Request Form


If you need to submit a request to Add, Update, or Deactivate an Insurance Provider, please complete the attached form, provide a copy of the insurace card front and back, complete proof of eligibility verification, include the encounter number, and submit it to Janice Jones at Do not attach any PHI to a Help Desk Ticket.

Insurance-Request.pdf Insurance-Request.pdf

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Article ID: 8
Category: Knowledgebase
Date added: 2016-08-10 20:45:23
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