clients
Mid-America Associates, Inc. is pleased to have you as a Client. On this page you will find various commonly used documents and forms.
Simply click on the document name below to view each file.
Forms & Downloads Advanced Control Formulary Advanced Control Specialty FormularySurprise Billing NoticePayment instructions and ACH authorizationPrecertification RequirementsDesignated Representative FormAuthorization To Release Confidential Medical Information MAAMulti-State Employee ApplicationCaremark Mail Order FormCaremark Reimbursement FormChange of Address FormDisabled Dependent APS FormGroup Change FormEligibility QuestionnaireWomen’s Cancer Annual NoticeMAA Self Funded Authorization To Release PHI FormPrior Authorization Referral FormHome Covid Testing Member Reimbursement Form
Simply click on the document name below to view each file.
Forms & Downloads Advanced Control Formulary Advanced Control Specialty FormularySurprise Billing NoticePayment instructions and ACH authorizationPrecertification RequirementsDesignated Representative FormAuthorization To Release Confidential Medical Information MAAMulti-State Employee ApplicationCaremark Mail Order FormCaremark Reimbursement FormChange of Address FormDisabled Dependent APS FormGroup Change FormEligibility QuestionnaireWomen’s Cancer Annual NoticeMAA Self Funded Authorization To Release PHI FormPrior Authorization Referral FormHome Covid Testing Member Reimbursement Form