TMPPM 2008 > Provider Information > TMHP Electronic Data Interchange (EDI) > Forms

   
 

3.8 Forms

The following forms are available in Appendix B, "Forms:"

"Electronic Remittance and Status (ER&S) Agreement (2 Pages)".

"Claim Status Inquiry (CSI) Authorization Form".

Note: Photocopy these forms and retain the originals for reuse.


Texas Medicaid & Healthcare Partnership
CPT only copyright 2007 American Medical Association. All rights reserved.
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