Related links
Medi-Cal Rx Provider Claim Inquiry Form (CIF) - CA.gov
Instructions: The Provider Claim Inquiry Form (CIF) is used to resolve claim payments or denials as identified on the Remittance Advice (RA).
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PROVIDER CLAIM ADJUSTMENT REQUEST FORM
Use this form as part of Sunshine Healths Provider Claims Inquiry process to request adjustment of claim payment received that does not correspond with payment
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Claim Form
Please complete every item on claim form. This completed form, together with the itemized bills, should be submitted to: Blue Cross and Blue Shield of Illinois.
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