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Request an Itemized Bill

We can send you an itemized bill for the health services you received. All you have to do is enter the information below and click “submit” to request a detailed statement of the services received by the patient. We will mail the statement to whoever is listed as the guarantor in our files.

Do you have questions about requesting or receiving an itemized bill? Just call us at 800-477-4035 during our regular business hours (Monday – Friday, 8 a.m. – 4:30 p.m). Our customer service representatives are glad to help.