ÃÛÌÒAPP

• Medical Claim Form (WebTPA)
• Prescription Drug Claim Form (MedImpact) 
• First Choice Provider Nomination Form
• ÃÛÌÒAPP First Prior Authorization Form
• WebTPA HIPAA Form
• MedImpact Rx HIPAA Form

• Care Coordination
• MedImpact Choice 90 Program
• MedImpact Direct Mail Flyer 
• Preventative Care Guide
• Bariatric Program
• Proration Grid
• The ABC's of Explanation of Benefits (EOBs)
• MedImpact – One Touch Meter
• MedImapct – Freestyle Meter

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• Medicare Part D Notice