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["For your convenience, here are a few hints for using the RHCD Invoice template:"]
[]
[]
["1.  Save this file on a drive that you access on a regular basis (so you have a clean invoice template for next "]
["     month's invoice)."]
[]
["2.  Using the \"Save As\" feature, save this file again with a name of your choice that is"]
["     appropriate for the invoice you are about to complete."]
[]
["3.  Enter information in the shaded areas only.  The information required is found on the "]
["     Support Schedule received from RHCD (with the exception of Service Prodiver Invoice Number - "]
["     you assign this number)."]
[]
["4.  If entering more than 20 line items, find additional invoice pages below page 1."]
[]
["5.  After all line items have been entered, verify the Total Invoice Amount located in the top section of the invoice."]
[]
["6.  To avoid printing blank invoice pages, specify the pages you have used in the Print Pages fields."]
[]
["7.  After printing, date, sign, print your name and phone number on the bottom of page 1."]
[]
["8.  Send the invoice to:  "]
[]
[null,null,"RHCD"]
[null,null,"80 South Jefferson Road"]
[null,null,"Whippany, NJ  07981"]
[]
["9.  If you have any questions, please contact Karen Mogensen at 973-581-6756 (e-mail:  kmogens@neca.org)."]

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[]
["RHCD SERVICE PROVIDER INVOICE"]
[]
[{"$nulls":5},"FOR RHCD USE ONLY"]
[{"$nulls":5},"Header Verification",{"$nulls":8},1]
["Service Provider Name",{"$nulls":4},"____","RHCD Processed Date"]
["SPIN",{"$nulls":4},"____","Number of Records"]
["Service Provider Invoice Number",{"$nulls":4},"____","Number of Records Approved"]
["Invoice Date to RHCD (mm/dd/yy)",{"$nulls":4},"____","RHCD Approved Total Amount "]
["Total Invoice Amount",null,null,0,null,"____"]
[]
[" ","Funding Year\n(yyyy)","HCP #","\nFunding Request #","Billing Account #","Multiple Months           (Y or N)","Support Date (mmyyyy)","Support Amount to be Paid by USAC",null,"Code"]
[1,{"$nulls":8},"____"]
[2,{"$nulls":8},"____"]
[3,{"$nulls":8},"____"]
[4,{"$nulls":8},"____"]
[5,{"$nulls":8},"____"]
[6,{"$nulls":8},"____"]
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[]
[]
["I certify that the information contained in this invoice is correct and that the health care providers and Billing Account Numbers listed above have been credited with the amount shown under \"Support Amount to be Paid by USAC\"."]
[]
["Signature:",{"$nulls":5},"Date:"]
[]
["Print Name:",{"$nulls":5},"Telephone # :"]
[]
[]
["RHCD SERVICE PROVIDER INVOICE"]
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["Service Provider Name",null,null,0]
["SPIN",null,null,0]
["Service Provider Invoice Number",null,null,0]
["Invoice Date to RHCD (mm/dd/yy)",null,null,"00:00:00"]
["Total Invoice Amount",null,null,0]
[]
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[]
[]
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["RHCD SERVICE PROVIDER INVOICE"]
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["Service Provider Name",null,null,0]
["SPIN",null,null,0]
["Service Provider Invoice Number",null,null,0]
["Invoice Date to RHCD (mm/dd/yy)",null,null,"00:00:00"]
["Total Invoice Amount",null,null,0]
[]
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["RHCD SERVICE PROVIDER INVOICE"]
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["Service Provider Name",null,null,0]
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["Invoice Date to RHCD (mm/dd/yy)",null,null,"00:00:00"]
["Total Invoice Amount",null,null,0]
[]
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[]
[]
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["RHCD SERVICE PROVIDER INVOICE"]
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["Service Provider Name",null,null,0]
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