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OTC (Over-the-Counter) Send completed form and ...

OTC (Over-the-Counter) Send completed form and ...

www.aetna.com

OTC (Over-the-Counter) Reimbursement Claim Form Send completed form and documentation to: Aetna PO Box 4000 Richmond, KY 40476-4000 Fax to: 1-888-238-3539 (1-888-AET-FLEX)

  Form, Aetna, Documentation, Completed, Over, Counter, Nedss, The counter, Send completed form, Send completed form and documentation

AUTHORIZATION FOR RELEASE OF INFORMATION

AUTHORIZATION FOR RELEASE OF INFORMATION

www.dukehealth.org

Apr 01, 2019 · send completed form to: ROI-requestor3@dm.duke.edu; Fax: 919-620-5165 OR Duke University Hospital - HIM P.O. Box 3016 Durham, NC …

  Form, Authorization, Completed, Nedss, Send completed form

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Over, The-Counter) Send completed form, The-Counter, Send completed form and documentation, Aetna, AUTHORIZATION, Send completed form