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IFHP Benefit Grid - Basic Coverage
IFHP Benefit Grid - Basic Coverage 1 Current as of 4/6/16 Benefit Description Benefit Code Effective Date Prior Approval Required ICD 9 / 10 Code or Written Dx Required Provincial Health Code Required
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MEMBER HEALTH CLAIMS SUBMISSION FORM
docs.medaviebc.caDate of Service daymonth year Type of Service diabetic supplies, ... Was treatment the result of an accident? Yes No If yes, please complete the following and attach details of the accident. ... PO Box 3300, Station B Montréal QC H3B 4Y5 Inquiries: 1-888-588-1212.