Member Claim Form Please use a separate claim form for each patient. Your cooperation in completing all items on the claim form and attaching all required documentation will help expedite quick and accurate processing. P - Superbill - Document - PDFSEARCH.IO

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	Member Claim Form Please use a separate claim form for each patient. Your cooperation in completing all items on the claim form and attaching all required documentation will help expedite quick and accurate processing. P Add to Reading List Document Date: 2014-08-30 22:28:48 Open Document File Size: 53,20 KB Share Result on Facebook Company Anthem / / Currency USD / / MedicalCondition injury / / Movie Pick-up / / Organization Blue Cross Association / / Person Pat Fogarty / Claim Form / John Wang / / / Position physician / Licensed Clinical Social Worker / Child Counselor / Audiologist / Speech Therapist / private duty nurse / / ProvinceOrState California / / Technology X-ray / / URL www.anthem.com/ca / / SocialTag Ambulance Medicine Health insurance Medical prescription Health Medical informatics Superbill Itemized deduction Taxation in the United States Emergency medical services

Member Claim Form Please use a separate claim form for each patient. Your cooperation in completing all items on the claim form and attaching all required documentation will help expedite quick and accurate processing. PAdd to Reading List