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Aetna Better Health of Louisiana Request for Appeal If you need this in larger type or another format, call Member Services at 18552420802 (TTY: 711) Blame how MIMO all 18552420802 (TTY: 711) is used DESE
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The request-appeal-larevised 13020 accessible pdf is a form used to file an appeal or request for reconsideration regarding specific administrative decisions, ensuring accessibility for users with disabilities.
Individuals or entities who wish to contest a decision made in administrative proceedings are required to file the request-appeal-larevised 13020 accessible pdf form.
To fill out the request-appeal-larevised 13020 accessible pdf, users should follow the instructions provided on the form, including entering personal details, specifying the decision being appealed, and attaching any necessary documentation.
The purpose of the request-appeal-larevised 13020 accessible pdf is to formally challenge an administrative decision, seek reconsideration, or request a review of the case.
The form requires the report of personal identification information, details of the decision being appealed, reasons for the appeal, and any relevant supporting documents.
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