IHS Inc, Downloadable Forms

Under the privacy rules of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) that took effect on April 14, 2003, it is required that an authorization form be completed on each participant over the age of 18. These privacy regulations protect individually identifiable protected health information (PHI) maintained by a group health plan.

The new HIPAA regulations have created a great deal of confusion when it comes to issues of privacy, especially when it comes to checking claim status for family members.

The most common HIPAA question has to do with checking claim status for a family member who is over the age of 18 (ie; spouse or adult child in school), in order to release any information concerning a family member who is over the age 18 we need a PHI Authorization form filled out by that family member stating who their information may be released to. This form is kept on file and referred to any time an inquiry is made..

PHI Authorization form

Download as a PDF or Word Document

Medical Claim Form

Download as a PDF or Word Document

Dental Claim Form

Download as a Word Document

Perscription Claim Form

Download as a Word Document

FSA Claim Form

Download as a Word Document

HRA Claim Form

Download as a Word Document

Contact Information

Fort Wayne, Indiana

IntraHealth Solutions, Inc.

111 East Ludwig Road, Suite 108

Fort Wayne, Indiana 46825

Phone: 877-755-4010

Fax : 260-969-4011

Email : info@intrahealthsolutions.com

Indianapolis, Indiana

IntraHealth Solutions, Inc.

1502 W. Edgewood Ave, Suite B

Indianapolis, IN 46217

(317) 791-5389

"Old fashion integrity with modern technology"

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