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CREDIT APPLICATION Holiday Inn Downtown 141 North 9th Street Lincoln, Nebraska 68508-1311 Phone: 402-475-1038 or 402-435-2837 Fax: 402-475-4366 COMPANY INFORMATION Legal Name: DBA: Address: City:
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What is new direct bill application?
The new direct bill application is a form used to request payment directly from a customer's insurance company.
Who is required to file new direct bill application?
Service providers such as healthcare providers, auto repair shops, and contractors are required to file the new direct bill application.
How to fill out new direct bill application?
The new direct bill application can be filled out online or in person by providing details about the services provided, customer information, and insurance details.
What is the purpose of new direct bill application?
The purpose of the new direct bill application is to streamline the payment process by allowing service providers to receive payment directly from the customer's insurance company.
What information must be reported on new direct bill application?
The new direct bill application must include details about the services provided, customer information, insurance policy number, and any relevant billing codes.
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