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EOB Submission
EOB Submission
SELECT INSURANCE COMPANY BELOW
*
HUMANA
SELECT HEALTH
AETNA
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How Much is the Total Indicated on the EOB?
(INDICATE “0” IF IT IS A REJECTION OR REQUESTING MORE INFORMATION)
How Many Pages are Being Uploaded?
reimbursement #
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Number of pages
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Upload EOB
Page 1
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Maximum file size: 516MB
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