If a patient is covered by more than one health plan, form locator 11d is answered Yes and form locators 9a-d must be completed.

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If a patient is covered by more than one health plan, form locator 11d must be answered Yes and form locators 9a-d must be completed to indicate the other insurance information. This is done to determine the coordination of benefits between the different health plans.

If a Patient Is Covered by More Than One Health