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Zelis Bill Review for Claim Appeal Form

Zelis Claim Appeal Submittal Form Bill Review Complete all information requested below and fax or email with a copy of complete medical records, itemized bills and a copy of the HCFA-1500 or UB-04 to (908) 658-3511 or [email protected].

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The Special Enrollment Period

All Montana and Wyoming residents now eligible for coverage*. Your plan could be free, or very low cost, with new tax credits.

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*2021 Individual Plans

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