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Inflected (infliximabdyyb) Injectable Medication Recertification RequestAetna Recertification Notification Phone: 18667527021 FAX: 18882673277Page 1 of 6 (All fields must be completed and legible
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Fill in your personal information, including your name, address, date of birth, and contact information.
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Provide your Medicare information, such as your Medicare number and any additional coverage you have.
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Anyone who is eligible for Medicare and has coverage under Aetna may need to fill out the medicare-gr-form-69299-3-inflectrapdf - aetna. This form may be required for various purposes, such as medication coverage, healthcare services, or claims processing. It is recommended to consult with Aetna or a healthcare professional to determine if this form is necessary for your specific situation.
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It is a form used for reporting Medicare information to Aetna.
Healthcare providers who have provided services to Aetna Medicare beneficiaries.
The form must be filled out accurately with all required information and submitted according to the instructions provided by Aetna.
The purpose is to report Medicare information related to services provided to Aetna beneficiaries.
Information such as patient demographics, services provided, dates of service, and billing codes must be reported.
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