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Interactive Medical Systems
Downloads & Forms
Standard Forms

  Other Coverage Verification Form   -   Executed online through Citrix's RightSignature

  Student Status Form   -   Executed online through Citrix's RightSignature

  Accident Information Form   -   Executed online through Citrix's RightSignature

  Authorization For Release Of Information Form   -   Executed online through Citrix's RightSignature

  Lost Check Agreement    -   Executed online through Citrix's RightSignature

  Continuity of Care Request Form

  Uniform Glossary of Health Coverage and Medical Terms

  Medical Claim Form - HCFA 1500

  Dental Claim Form   -   Executed online through Citrix's RightSignature

  Dental Claim Form

  Vision Claim Form   -   Executed online through Citrix's RightSignature

  Vision Claim Form

  Disability Claim Form



Section 125 Cafeteria Plans / Flexible Spending Accounts / Health Reimbursement Arrangement

  Flexible Spending Account Claim Form

  Request Form for Issuance of Additional Flex Debit Cards

  Health Reimbursement Arrangement (HRA) Claim Form

  Over-the-Counter Medicines - Quick Reference Guide


General Information

  No Surprises Act - Understanding your rights and protections from surprise medical bills


  Services Provided by Interactive Medical Systems


Machine Readable Files

  Interactive Medical System's Website for Machine Readable Files