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Medical Claim Procedures To request reimbursement for expenses, you will need a copy of the medical insurance claim form. This claim form must be completed in full, and submitted to the claim office with complete documentation. On the top of the form, you must include the group insurance company name and policy number listed below: Combined Insurance Company of America. The policy number is GLB 9709600 (0810-2539) (06). Claim Procedures:
For prescription drug claims, attach the
itemized doctor/hospital bill along with the receipt from the pharmacy for
the drug, along with the name/description of drug. P.O. Box 659570 San Antonio, Texas 78265-9570 Telephone: 1-800-456-7480 Fax: 1-210-822-4113
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