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 Davis Vision Claim Fax Number Form 2009

Davis Vision Claim Fax Number Form 2009

Use a Davis Vision Claim Fax Number Form 2009 template to make your document workflow more streamlined.

Signed the form, and that all services, charges, and service dates have been entered. If the form is incomplete, additional information may be required. This may result in a delay of payment for eligible benefits. 4. Please submit claim reimbursement for each patient on a separate claim form. 5. Please note that the member’s (or employee’s or authorized person’s) signature is required on this form. 6. Mail completed claim form to: Vision Care Processing Unit, P.O. Box 1525, Latham, NY 12110. 7....
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