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Get and Sign REQUEST for DECISION on UNPAID HP 1 MEDICAL BILLS 2020-2022 Form
Insurance carrier or self-insured employer for payment within 120 days from the day the service(s) was rendered. The medical bill(s) must contain all treatment rendered by a provider on a single day; AND C. A minimum of 45 days has elapsed since the submission of the medical bill(s); AND D. The provider has NOT received proper payment in accordance with the applicable Fee Schedule; AND E. NO related Denial of Claim or Form C-8.1 [Notice of Treatment Issue(s)/Disputed Bill Issue(s)] has been...Show details
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