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Standard Notice: Patient and Provider Settle on a Payment Amount After Initiating Patient-Provider Dispute Resolution
ICR 202109-0938-015 · OMB unassigned · Object 115428501.
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Document Metadata
| File Type | application/octet-stream |
|---|---|
| File Title | Standard Notice: Patient and Provider Settle on a Payment Amount After Initiating Patient-Provider Dispute Resolution |
| File Modified | 2021-09-24 |
| File Created | 2021-09-23 |
| Conversion State | complete |