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Time Loss Claim Form ALASKA ... - WPAS, Inc. 2025

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The document is a Medical/Dental/Time Loss Claim Form for the Alaska Laborers Health and Security Fund, detailing the process for submitting claims for medical, dental, or time loss benefits. It includes sections for employee and patient data, other insurance information, claim details related to accidents, and an authorization statement for processing claims. Instructions emphasize the need for itemized bills and proper completion of the form to avoid delays.

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2014	4.7 Satisfied (26 Votes)

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