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 MAA Privacy Notice LULAC Privacy Notice Children’s Health Insurance Program Notice MAA HIPAA Authorization To Release Medical Information Mid-America Appeal ProceduresSurprise Billing NoticePayment instructions and ACH authorizationPrecertification RequirementsDesignated Representative FormMulti-State Employee ApplicationCaremark Mail Order FormCaremark Reimbursement FormChange of Address FormDisabled Dependent APS FormGroup Change FormEligibility QuestionnaireWomen’s Cancer Annual NoticePrior Authorization Referral Form
Simply click on the document name below to view each file.
Forms & Downloads MAA Privacy Notice LULAC Privacy Notice Children’s Health Insurance Program Notice MAA HIPAA Authorization To Release Medical Information Mid-America Appeal ProceduresSurprise Billing NoticePayment instructions and ACH authorizationPrecertification RequirementsDesignated Representative FormMulti-State Employee ApplicationCaremark Mail Order FormCaremark Reimbursement FormChange of Address FormDisabled Dependent APS FormGroup Change FormEligibility QuestionnaireWomen’s Cancer Annual NoticePrior Authorization Referral Form