Uft ship claim form 2025

1. Click ‘Get Form’ to open the uft ship claim form in the editor.
2. Begin by entering your last name and first name in the designated fields. If you are the member, simply write 'Same' for the patient's first name.
3. Fill in your address, including apartment number, city, state, and zip code. Ensure all information is accurate for smooth processing.
4. Provide both your Social Security number and the patient's Social Security number. Also, enter the patient's birth date in the specified format (Month-Day-Year).
5. Indicate whether the patient is on Medicare by checking the appropriate box.
6. Sign and date at the bottom of the form. If applicable, ensure that a spouse signs if submitting a claim for them.
7. Review all sections to confirm completeness before submitting. Remember to attach any required documentation as outlined in the instructions.

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