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Get and Sign New York State Out of Network Surprise Bill  Form

Get and Sign Nys Out of Network Surprise Bill Form

Use a nys out of network surprise bill template to make your document workflow more streamlined.

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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