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ihbs Integrated Healthcare Business Solutions, Inc.

9875 South Franklin Dr.


Suite 300
PO Box 320930 Tel: 414.858-2200
Franklin, WI 53132 Fax: 414.858-2230

SERVICING

This letter is to request your assistance in securing payment for a physician that has
provided service to you. You visited on . Your insurance company, , has requested
certain information from you. Please call the number on the back of your insurance
card, or call our office for a contact number, and give the information they are
looking for.

Please note that you cannot be billed for this service, regardless of the answers you
provide . For this date of service you are covered under the Medicaid program for
the state of Wisconsin. This prohibits health care providers from billing you for
services, besides what Medicaid approves, usually $1-3. If you do not contact your
insurance, the physician that treated you will not be paid for his effort because
Medicaid will not pay until your insurance pays. Your assistance in this matter
would be greatly appreciated. If you have any questions or concerns, please feel
free to contact me with the information below.

Thank you for your time

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