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Return To: Counter Health Plan ATTN: Valence Compliance 540 W. Madison St, Suite 1500 Chicago, Illinois 60661 Fax: (312) 5489940REQUEST TO AMEND PROTECTED HEALTH INFORMATION (PHI) Use this form to

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What is return to countycare health?

Return to countycare health is a form that needs to be submitted to report information related to an individual's healthcare coverage and expenses.

Who is required to file return to countycare health?

Individuals who have received healthcare coverage through countycare health are required to file a return to countycare health.

How to fill out return to countycare health?

You can fill out return to countycare health either online or by mail, providing all the required information related to your healthcare coverage and expenses.

What is the purpose of return to countycare health?

The purpose of return to countycare health is to ensure that individuals are reporting accurate information about their healthcare coverage and expenses.

What information must be reported on return to countycare health?

Information such as healthcare coverage details, expenses incurred, and any subsidies or credits received must be reported on return to countycare health.

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