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Click here for Electronic Billing and Payment Services!!!

One Insurance

One Insurance Page 1 Date of Service Guarantor Guarantor Guaranto Address Location Account Number For Credit Card Payment Statement Date Primary Insurance Secondary Insurance Amount we are billing your insurance

One Insurance Page 2 What You Owe Now Date of Service Location About your insurance About you Hospital Summary of Charges Account Number

 

Last modified on: July 26, 2004

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Patient Financial Services

PO Box 800750

Charlottesville, VA 22908

1-800-523-4398

tdd: 434-982-HEAR

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