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 Provider Bulletin July Med Manualzz Com Med Quest 2014-2023

Provider Bulletin July Med Manualzz Com Med Quest 2014-2023

Use a manualzz 2014 template to make your document workflow more streamlined.

To Claims P. Hawaii Medicaid Fiscal Agent 1132 Bishop Street Ste. 800 Honolulu HI 96813 1. Date of Inquiry FORM 239 Medicaid Correspondence Inquiry 2. Provider Name Last First Middle Initial Form 3. Provider Number 4. Address Pay to Address Service Address 5. Telephone Number 6. Name of Contact 7. Claim Number if applicable 8. Purpose of Inquiry Questionable Payment Claims Filing Procedure Claim Status Other Do not use this form for claim adjustments. Patient ID Number 11. Dates of Service 12....
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