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Field 11 d - Is There Another Health Benefit Plan
Posted by Dan Perrine, Last modified by Dan Perrine on 28 March 2018 06:49 AM

“Is there another health benefit plan” indicates that the patient has insurance coverage other than the plan indicated in Item Number 1.

INSTRUCTIONS: When appropriate, enter an X in the correct box. If marked “YES”, complete 9, 9a, and 9d. Only one box can be marked.

MEDICARE - Leave blank. Not required by Medicare.


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