Provider Dispute Resolution Form
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Dispute Resolution Form
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Web health care provider dispute resolution (ca delegates, or hmo claims, or and wa commercial plans) if you disagree with our claim determination, you must initiate and. Use this form when requesting scan assistance with delegate disputes the preferred and most efficient. Web friday 8:00 am to 5:00 pm pst or visit our secure provider portal available for contracted providers at www.iehp.org. Signnow allows users to edit, sign, fill & share all type of documents online.
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