800 589 8911
Fax: 317 329 3080
Payment Activity Under
Liquidation
Frequently Asked Questions
** Legal Documents **
Provider Claim Forms
HIPAA Procedure Statements
Health Information Privacy Procedures
for Medical Savings Insurance Company
Authorization for Release of Health Information
Disclosure Record
Individual Request to Inspect Health Information
Group Health Plan’s Response
to Inspection Request
Individual Request to Correct
or Amend a Record
Request for Accounting of Disclosures
of Protected Health Information
Disclosure Accounting
Individual Request Not to Use
or Disclose Health Information
Confidential Communication Request
Administrative Designations
Notice of Guaranty Association
Privacy Procedures
Medical Savings Insurance Company
Copyright © 2009 Medical Savings Insurance
5835 W. 74th Street
P.O. Box 68961
Indianapolis, IN 46268-0961
To read our HIPAA procedures statement click here.
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