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Jade 15 Platinum Individual & Family Plan /Combined Evidence of Coverage and Disclosure Form DMC Approval Date 9/18/2019 Jade 15 Platinum HMOEOC20IFPOFFJ15CH.docx
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Jade 15 Platinum HMO is a specific health maintenance organization (HMO) plan that offers a range of healthcare services to its members, typically focusing on preventive care and cost-effective health management.
Individuals or organizations that are enrolled in the Jade 15 Platinum HMO plan are typically required to file documentation regarding their plan usage and healthcare expenses.
To fill out the Jade 15 Platinum HMO, members should follow the specific guidelines provided by the HMO provider, including providing personal information, details on healthcare services utilized, and any necessary supporting documentation.
The purpose of Jade 15 Platinum HMO is to provide comprehensive healthcare services to its members while managing costs and promoting preventive care strategies.
Information that must be reported typically includes member identification details, a summary of health services used, provider information, and any relevant medical or billing records.
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