Submit a Woman's Choice Program Claim
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To file a claim for the Woman’s Choice Program, the patient must be accompanied by their surgeon and submit the required documentation as follows:
- Woman's choice program claim form signed by patient and surgeon.
The following information is required to verify eligibility for reimbursement.
- Proof of explantation: e.g., a document from the clinic/surgeon that refers specifically to an explantation performed on a specific date.
- Invoices of the explantation surgery.
See the Terms and Conditions.
Submit a claim through this form with the requested documents.
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