Care One Plan

$442$ Main St$.$

Rochester, NY $14995$

RE: Jamieson, Allision $($DOB $10/27/1997)$

HIC #: $116532986F$

DOS: $05/07/20$YY

It has come to our attention that the attached claim was denied because si

Please note that the claim was submitted in good faith and in a timely manner.

The claim and

are attached for your review. Please feel free to contact me if you have any further regarding this claim.

Thank you for your consideration of this matter.

Sincerely,

Regina Labrecque

Billing Coordinator

Enc.