Provider Claim Dispute Use this form as part of the CountyCare Health Plan Claim Dispute process to dispute the decision made during the request for reconsideration process. NOTE: Prior to submitting a Claim Dispute, the - Health claim - Document - PDFSEARCH.IO

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	Provider Claim Dispute Use this form as part of the CountyCare Health Plan Claim Dispute process to dispute the decision made during the request for reconsideration process. NOTE: Prior to submitting a Claim Dispute, the Add to Reading List Document Date: 2015-02-25 12:00:15 Open Document File Size: 47,95 KB Share Result on Facebook

Provider Claim Dispute Use this form as part of the CountyCare Health Plan Claim Dispute process to dispute the decision made during the request for reconsideration process. NOTE: Prior to submitting a Claim Dispute, theAdd to Reading List