CSHCN 2009 > TMHP Electronic Data Interchange (EDI) > Forms

36.11 Forms

The following forms are available in Appendix B, "Forms," on page B-1:

•Claim Status Inquiry (CSI) Authorization on page B-123

•Electronic Funds Transfer (EFT) Information and Authorization Agreement on page B-124

Note: Photocopy these forms and retain the originals for reuse. Forms are also available at www.tmhp.com.

Refer to: Section 5.8, "Reimbursement".