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Master Claim Itemization Table Instructions

The Division of Rehabilitation and Liquidation (“Receiver”) has developed various Master Claim Itemization Tables to assist medical providers, agents and other general creditor claimants that have provided multiple goods or services to a receivership estate and thus have multiple invoices. In these situations, the medical provider, agent or general creditor is considered as one claimant and all their invoices equal the total amount of their claim.

The Master Claim Itemization Tables take into consideration whether the claimant is a medical provider or non-medical provider. If you are a medical provider that has multiple invoices for medical goods and services provided, please click on the Medical Provider Master Claim Instructions link below. If you are another claimant type such as a agent or general creditor that has multiple invoices for non-medical goods and services provided, please click on the Non-Medical Provider Master Claim Instructions link below. Claims submitted in a format other than what is specified may delay evaluation of your claim(s) or result in the rejection of your claim in its entirety.

Medical Provider Master Claim Instructions

Non-Medical Provider Master Claim Instructions

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