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The key facts should cover the 5 Ws: who, what, where, when and why. This is the short story version of what happened. From reading the claim, the story should be understandable. The short story also need to cover facts that make out any cause of action pled.

A HCFA 1500 form is used by the Health Care Financing Administration. It is used for health care claims. It is used to submit a bill or charge for health insurance coverage. This could be through Medicare, Champus, group health care, or other forms of insurance.

Statement of Claim Defined A Statement of Claim is legal notice filed by a person (called the Plaintiff) who seeks a judgement against you in Court. The Plaintiff prepares a Statement of Claim and files it in the Court of Queen's Bench.

You should respond to the counterclaim as though it were a Statement of Claim and you were drafting a Defence:respond to every paragraph you can do this paragraph by paragraph if necessary;deny any allegations of fact that you do not admit you will be deemed to admit facts that you forget to plead to; and.More items...

Steps to sue someone in Small Claims CourtDecide if you want to sue someone. You might be able to solve the problem another way.Start a claim.Wait for a response.Go to court.If you win the case, the court will ask the person or business you are suing to pay you.

Enter the patient's mailing address and telephone number. On the first line enter the street address; the second line, the city and state; the third line, the ZIP code and Page 2 Instructions on how to fill out the CMS 1500 Form telephone number. If Medicare is primary, leave blank.

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