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This form must be completed for each new physician, hospital, or other provider that becomes a participating HealthShare provider. This form lets HealthShare™ know what facilities the provider practices at and where claims reimbursement should be directed to.
Click here to open the form. |
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Complaint Resolution Form |
Use this form:
- To appeal a claim denial or payment outcome
- To provide feedback regarding the HealthShare™ program
Click here to open the form. |
