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The staff will assist you with constructing your appeal and submitting it to the insurance company. PLEASE DO NOT STAPLE File Number office use only NORTH CAROLINA DEPARTMENT OF INSURANCE HEALTH INSURANCE SMART NC 855-408-1212 PLEASE PRINT REQUEST FOR ASSISTANCE An online version of this form is available at www. PLEASE LET US KNOW HOW YOU HEARD ABOUT US State Fair NCDOI Speaker Other Please specify Radio Newspaper Internet N.C. Department staff will assist you with your complaint if...
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