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Get and Sign Nys Surprise Bill Form PDF
Services at 1-800-342-3736.
A surprise bill is when:
1. You received services from a non-participating physician at a participating hospital or ambulatory surgical
center, where a participating physician was not available; or a non-participating physician provided services
without your knowledge; or unforeseen medical circumstances arose at the time the services were provided. You
did not choose to receive services from a non-participating physician instead of from an available...
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