• Po box 2831 clinton iowa 52733

    Central Regional Office LBJ Freeway, Suite Dallas, TX Address: P.O. Box , Clinton, IA Phone: MAIL COMPLETED CLAIM FORM AND ITEMIZED BILLS TO: Submit claims to: Coresource PO Box Clinton, IA When a claim, be sure to include your nine digit identification number (8 numeric digits in E). This number can be found on the front of your identification card. Welcome to the world of Gallagher Bassett, the premier Claims Services Provider. We guide those a loss to the best outcomes for their futures. We guard our clients’ names and assets with unrivaled products and service. And we go beyond expectations in the continuous pursuit of a better way. Guide. Guard. Go po box · clinton iowa. PO Box Clinton, IA State of Nevada Medical Bills Gallagher Bassett Services, coffeeqaru.biz Size: 82KB. P.O. Box Clinton, IA (Fax ) Note: If injury was not a result of employment, this form serves only as a request for examination and report. NAME OF EMPLOYER BODY PART(S) INJURED DESCRIPTION OF NAME OF PERSON THIS FORM SIGNATURE LOCATION DESIGNATED MEDICAL PROVIDER ADDRESS NAME OF . PO Box • Clinton, IA • Fax Dear Medical Provider: The Illinois Worker’s Compensation and Diseases Act provides that the employer is obligated to pay all medical, hospital and surgical charges incurred in connection with an injury and/or disease. P.O. Box Clinton, IA Referrals & Authorizations. Providers should fax their treatment request to The Utilization Management Unit can also be reached by phone at . Location of This Business PO Box , Clinton, IA BBB File Opened:7/5/ Years in Business Business Started: separately incorporated Better Business Bureau organizations in the. What's ? is a ZIP Code 5 Plus 4 number of (From To ) PO BOX, CLINTON, IA, USA. Below is detail information.
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