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
Surprise Billing Notice
Payment instructions and ACH authorization
Precertification Requirements
Designated Representative Form
Authorization To Release Confidential Medical Information MAA
Multi-State Employee Application
Caremark Mail Order Form
Caremark Reimbursement Form
Change of Address Form
Disabled Dependent APS Form
Group Change Form
Eligibility Questionnaire
Women’s Cancer Annual Notice
MAA Self Funded Authorization To Release PHI Form
Prior Authorization Referral Form
Home Covid Testing Member Reimbursement Form