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HEALTH QUARTERLY STATEMENT AS OF JUNE 30, 2016, OF THE CONDITION AND AFFAIRS OF THEHealthSpring of Tennessee, Inc. NAIL Group Code09010901(Current)(Prior)Organized under the Laws FNAC Company CodeTennessee11522Employer's
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To fill out the 11522 Healthspring of Tennessee form, follow these steps:
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Start by entering your personal information, including your name, address, and phone number.
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Provide your social security number and date of birth.
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Indicate whether you are applying for yourself or someone else.
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Specify the type of coverage you are applying for, such as Medicare, Medicaid, or CHIP.
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Enter the necessary details about your current healthcare coverage, if applicable.
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Provide information about your income and household size to determine your eligibility.
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Answer any additional questions about your health and medical history as required.
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Review your form for accuracy and completeness before submitting it.
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Sign and date the form.
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Submit the completed form via mail or online, as instructed by Healthspring of Tennessee.

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11522 Healthspring of Tennessee is a form used for reporting health information for individuals residing in Tennessee.
Healthcare providers and organizations in Tennessee are required to file 11522 Healthspring of Tennessee.
To fill out 11522 Healthspring of Tennessee, healthcare providers need to report specific health information of individuals as per the guidelines provided in the form.
The purpose of 11522 Healthspring of Tennessee is to collect health information of individuals residing in Tennessee for record-keeping and healthcare management purposes.
Information such as medical history, treatments, prescriptions, diagnosis, and other relevant health data of individuals must be reported on 11522 Healthspring of Tennessee.
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