![](https://www.pdfsearch.io/img/4cf63ec3545565224063dfc4b984fadd.jpg) Date: 2013-08-13 20:01:28
| | HASSLE FACTOR FORM Please complete this HIPAA compliant form to report insurance administrative and claims processing concerns including settlement disputes that you may have filed. This data is confidential and assists Add to Reading ListSource URL: ny2aap.orgDownload Document from Source Website File Size: 163,37 KBShare Document on Facebook
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