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MILEAGE REIMBURSEMENT TRIP LOG & INVOICE FORM Must be sent to: Logistical Solutions- Attn: Claims 2552 West Erie Drive Suite 101 Tempe, AZ 85282 Logistical Billing Department: 1-866-570-6143 ext.
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How to fill out logisticare log sheets tempe:

01
Start by gathering all the necessary information, such as the date, time, and location of each trip.
02
Fill in the client's name and identification number, if applicable.
03
Record the pick-up and drop-off addresses accurately.
04
Indicate the mode of transportation used, whether it's an ambulance, wheelchair van, or other type of vehicle.
05
Log the number of miles traveled for each trip.
06
Note the purpose of the trip, whether it's for medical appointments, therapy sessions, or other reasons.
07
Include any special instructions or accommodations required for the client during the trip.
08
Finally, sign and date the sheet to certify its accuracy.

Who needs logisticare log sheets tempe:

01
Transportation providers who offer non-emergency medical transportation services.
02
Caregivers or family members responsible for scheduling and coordinating transportation for individuals with medical needs.
03
Insurance companies or healthcare facilities that require documentation of transportation services for billing or reimbursement purposes.
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Logisticare log sheets tempe are forms used to keep track of transportation services provided by Logisticare in the city of Tempe.
Transportation providers who offer services through Logisticare in Tempe are required to file logisticare log sheets.
Logisticare log sheets tempe should be filled out by entering the required information such as date, time, pickup location, drop-off location, passenger name, and any additional details about the transportation service.
The purpose of logisticare log sheets tempe is to accurately record and track transportation services provided by Logisticare in Tempe.
Logisticare log sheets tempe require the reporting of information such as date, time, pickup location, drop-off location, passenger name, and any additional details about the service.
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logisticare log sheets tempe az LogistiCare Mgr 2007 ext Clinician AZ REIMBURSEMENT Attn herein certify Erie Tempe Voucher INVOICE

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