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MILEAGE REIMBURSEMENT TRIP LOG AND INVOICE Mail to: Medicare Claims Department 798 Park Avenue NW, Norton, VA 24273 Phone: 8669075 1 8 6, F an x : 8 6 6 5 2 8 0 4 6 2 E M AI l : V i r g i NI a . Bi

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How to fill out mail to modivcare claims

01

Start by addressing the mail to ModivCare Claims department.

02

Include your personal information such as your name, address, and contact number.

03

Provide your ModivCare member ID or any other identification number that they require.

04

Clearly state the purpose of your mail, which is to file a claim.

05

Explain the details of your claim, including the date of service, the healthcare provider's name, and a description of the service or treatment received.

06

Attach any supporting documents such as medical receipts, bills, or insurance forms.

07

Make sure to sign and date the mail before sending it.

08

Double-check all the provided information and keep a copy of the mail for your records.

09

Finally, send the completed mail to the ModivCare Claims department using the appropriate mailing address.

Who needs mail to modivcare claims?

01

Anyone who has received healthcare services covered by their ModivCare plan and needs to file a claim for reimbursement or coverage. This could include individuals who have visited doctors, hospitals, or other healthcare providers and are seeking financial assistance or reimbursement for the expenses incurred.

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What is mail to modivcare claims?

Mail to modivcare claims is a process of submitting claims to ModivCare through postal mail.

Who is required to file mail to modivcare claims?

Individuals who are seeking reimbursement for medical expenses covered by ModivCare are required to file mail to modivcare claims.

How to fill out mail to modivcare claims?

To fill out mail to modivcare claims, you need to provide details of the medical services received, expenses incurred, and any supporting documentation.

What is the purpose of mail to modivcare claims?

The purpose of mail to modivcare claims is to request reimbursement for eligible medical expenses covered by ModivCare.

What information must be reported on mail to modivcare claims?

Information such as the date of service, services provided, healthcare provider details, and total expenses incurred must be reported on mail to modivcare claims.

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