Sep 30, 2025 · Sunshine Health: Enter the check number or EFT number that Sunshine Health has made payment(s) to you. Sunshine Health: Enter the payment date(s) for which the claims below …

: This spreadsheet is intended to communicate specific information regarding claims to Short Doyle Medi-cal for the purpose of ensuring accuracy of claims submitted by Sacramento County on behalf …

Jul 29, 2021 · Welcome to the VALERI claims import spreadsheet. This spreadsheet is a tool that will allow your organization to submit bulk claims to the Department of Veterans Affairs using the …

Claims Customer Service Mon - Fri 08:00 AM - 06:00 PM in your time zone. Visit Availity - utilize secure “Chat with TriWest” feature or give us a call at (877) 226-8749. Please make sure to complete this …

52 Regular Unemployment Insurance Initial Claims, by Claim Week, 2024-2025*** Week Processed Ending Date Initial Claims Change From Prior Week Percentage Change From Prior Week 4-Week …

P. No. of Claims in which PTD Benefits were paid in FY25 (NRS 616C.440) Q. No. of Claims in which Death Benefits were paid in FY25 (NRS 616C.505) R. No. of Injured Employees Paid Rehabilitation …

If you are emailing this form and claim details: 1) Include your refund check number, as well as the dollar amount of the check, in the subject line. 2) Password protect this form and your Excel template. …

36.) Original DCN if Corrected Claim: Please Mail, Fax or E-Mail this form to: Community Care, Inc. Attn: Claims Processing P.O. Box 923 Brookfield, WI 53008-0923 FAX

To be Completed by Customer to file a Rebuttal on a Denied Claim. Service Order Number. Tracking Number. For Company Use Only . Contact Name. Frontier - Wholesale Claims Spreadsheet. Send …

- If you disagree with the outcome of the dispute, enter the claims and issues on this template and coordinate with your dedicated Provider Network Manager (PNM)