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Nys Surprise Bill Form. Your health plan must pay your health care provider, and. Sign a surprise bill certification form.
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Use this form if you receive a surprise bill for health care services and want the. You must sign a surprise bill certification form if: Your health plan must pay your health care provider, and. Web new york state surprise medical bill certification form. You are protected from surprise medical bills. Use this form if you receive a surprise bill for health care services and want the. Sign a surprise bill certification form.
