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Get Wageworks GEN 7003.2 (WW-6949-HIPAA-PPT-AUTH) 2012-2024

Hip to Individual:__________________________________________________________ AFTER YOU HAVE SIGNED THE AUTHORIZATION, KEEP A COPY FOR YOUR RECORDS. Submit to: WageWorks, Inc. Fax: (866) 672-3703 Claims Administrator PO Box 14053 Lexington, KY 40512 GEN.7003.2 WW-6949-HIPAA-PPT-AUTH (Aug 2012) .

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