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Medical Expense Form

WebHere you can submit a Medical Expense Form electronically. The video below explains the information needed to process the form. Please give us a call if you have any questions …

Actived: 7 days ago

URL: https://app.impacthealthsharing.com/forms/medical-expense

Extra Impact Application

WebExtra Impact is meant to help members with ineligible medical expenses. Every application is reviewed on a case by case basis and dependent on the amount of funds available at …

Category:  Medical Go Health

Pre-Eligibility Form

WebPre-Eligibility. Please allow 3-5 business days for the sharing determination to be made. For urgent requests, please select urgent request below. Please be advised that pre …

Category:  Health Go Health

Provider Assistance Form

WebPROVIDER ASSISTANCE FORM. If your provider is unsure or unwilling to accept Impact, please fill out the form below and we will reach out to educate them on how Healthcare …

Category:  Health Go Health

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