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Mail completed form to: Fax to: Customer Service: REIMBURSEMENT REQUEST FORM Maritain Health P.O. Box 30111 Lansing, MI 48909 888.837.3725 800.748.0003 Employer Name: Employee Name: SS# or ID#: Address:
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What is mail completed meritain health?
Mail completed Meritain Health is a form that needs to be filled out to report completed health services.
Who is required to file mail completed meritain health?
Employers and health service providers are required to file mail completed Meritain Health.
How to fill out mail completed meritain health?
Mail completed Meritain Health can be filled out online or through a paper form provided by Meritain Health.
What is the purpose of mail completed meritain health?
The purpose of mail completed Meritain Health is to report completed health services for billing and record-keeping purposes.
What information must be reported on mail completed meritain health?
Information such as patient details, services provided, dates of service, and billing information must be reported on mail completed Meritain Health.
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