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EXTENDED HEALTH CLAIM Please print your Firm & Certificate #EMPLOYEE INFORMATION1Firm #Certificate #Firm Name Employees Full Name Home Mailing Addressing / TownApartment/StreetProvincePlease provide
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How to fill out extended health claim

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How to fill out extended health claim

01
Obtain an extended health claim form from your health insurance provider.
02
Read the instructions on the form carefully to understand what information is required.
03
Fill out your personal details such as your name, address, and contact information.
04
Provide your health insurance policy number and any other relevant identification numbers.
05
Document the date of the health service or treatment for which you are making a claim.
06
Describe the nature of the health service or treatment and the reason for seeking it.
07
Attach any supporting documents such as medical receipts, doctor's notes, or prescriptions.
08
Review the completed form to ensure all necessary information is included.
09
Submit the filled-out claim form along with the supporting documents to your health insurance provider.
10
Keep a copy of the claim form and supporting documents for your records.

Who needs extended health claim?

01
Anyone who has extended health coverage through their health insurance policy may need to fill out an extended health claim. This can include individuals who have received medical services not covered by their basic health insurance plan or individuals who have incurred out-of-pocket expenses for health-related treatments.
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Extended health claim is a request for reimbursement of medical expenses beyond basic health coverage.
Individuals who have incurred medical expenses that are covered under their extended health insurance policy.
Extended health claims can usually be submitted online or through a paper form provided by the insurance company. The form must be filled out with details of the medical expenses incurred.
The purpose of extended health claim is to request reimbursement for medical expenses that are not covered under basic health insurance.
Information such as date of service, type of medical service received, cost of service, and any supporting documentation must be reported on extended health claim form.
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