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Arizona
Health Care Provider Timely Payment and Grievance Law - Regulatory Bulletin 2006-021
California
Connecticut
Florida
Massachusetts
New Jersey
Radiology and Imaging
Physical and Occupational Therapy
Chiropractic Services
Present on Admission Indicator Code
Continuation of benefits due to total disability form
Handicapped Child Attending Physicians Statement (for behavioral health conditions of all ages and medical conditions for dependents age 18 and younger).
Adult Medical Attending Physician Statement (for medical conditions for subscribers and dependents over the age of 18).
Nonparticipating Facility Itemized Bill Review
Provider Appeal Procedure
New Claims Review Process for observation room charges