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NEIGHBORHOOD HEALTH PLAN ERA CONTRACT INSTRUCTIONS (04293) FAX or EMAIL the completed and signed authorization letter to: MD On-Line ATTN: Enrollment 888-837-2232 setup mdol.com THIS LETTER MUST BE
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What is this letter must be?
This letter must be a formal document requesting specific information or action.
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The party identified in the instructions or regulations is required to file this letter.
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The purpose of this letter must be to communicate important information or request a specific action.
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The information that must be reported on this letter will depend on the specific requirements outlined in the instructions.
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