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Regional Home Health & Hospice Intermediary (RHHI)
Duplicate Remittance Advice Form

The Duplicate Remittance Advice Request Form has been revised and is now available online. Please note: The form is now interactive. It can be completed online, printed and then mailed...no more filling the form out by hand!
Select View Attachments to print or download this form.

 

last updated on 03/13/2008