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The document outlines the process for submitting claims for medical services received outside the United States under the Foreign Medical Program (FMP). Claims must be submitted within two years of service or discharge, and must include itemized billing statements and any relevant Explanation of Benefits from other health insurance. It details required information for claim submission, including provider details and patient certification. The document also includes privacy and legal disclaimers regarding the use of personal information.
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Google Forms is free online software that allows you to create surveys, quizzes, and more. Google Forms is part of Googles web-based apps suite, which also includes Google Docs, Google Sheets, Google Slides, and more.
Steps to Create a Fillable Form in Word Step 1: Open Microsoft Word. Launch Microsoft Word on your computer and create a new document. Step 2: Enable the Developer Tab. Step 3: Insert Form Fields. Step 4: Customize Field Properties. Step 5: Protect the Form. Step 6: Save and Distribute.
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