Fillable uft ship forms

Please read reverse side for limitations and required documentation needed to submit a claim Claims must be filed within 1 year of the date of service or payment by health plan whichever is later SHIP Claim Form UFT/RTC Supplemental Health Insurance Program SHIP Mail Claim Form to SHIP P. C. Private Duty Nursing 9. Nurse s/Home Health Aide s D. Surgery/Anesthesia 10. Orthopedic Shoes Do Not Write In Area Below...
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uft ship forms