This is a legal form that was released by the Delaware Department of Insurance - a government authority operating within Delaware. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form C?
A: Form C is a document used to prove the service of papers for non-network providers of emergency care services.
Q: Who is required to use Form C?
A: Non-network providers of emergency care services are required to use Form C.
Q: What is the purpose of Form C?
A: The purpose of Form C is to provide proof of service of papers for reimbursement of emergency care.
Q: What is Health Care Reimbursement for Emergency Care Arbitration?
A: Health Care Reimbursement for Emergency Care Arbitration is a process to resolve disputes between non-network providers of emergency care and health plans.
Form Details:
Download a fillable version of Form C by clicking the link below or browse more documents and templates provided by the Delaware Department of Insurance.