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NEW ENROLLMENT CHANGE ENROLLMENT APPLICATION P.O. BOX 928 TOLEDO, OHIO 43697-0928 (419) 887-2525 1-800-462-3589 PLEASE PRINT DO NOT WRITE IN SHADED AREAS USE BALL POINT PEN PRESS HARD MAKE SURE APPLICATION
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Subscriber - paramount health is an individual or entity who is enrolled in a health insurance plan with Paramount Health.
Any healthcare provider or entity that has provided services to a subscriber with Paramount Health may be required to file subscriber information.
To fill out subscriber information for Paramount Health, providers must include details such as name, date of birth, policy number, and services provided.
The purpose of subscriber information for Paramount Health is to ensure accurate billing and reimbursement for healthcare services provided.
Information such as subscriber's name, date of birth, policy number, diagnosis codes, and services provided must be reported.
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