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– A separate form is required for each patient medical information request – We are committed to protecting the privacy of our policyholders.  InsuranceTPA privacy rule is established to  protect written, spoken and electronic information. Any health information collected will be secured by our Privacy Rule to assure that policyholders information is properly protected.

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Use electronic claims submission:
Electronic Payor Id: 39182

If Unable to Submit Electronically

Please MAIL CLAIMS TO:
InsuranceTPA.com
PO BOX 15953
Lubbock, TX 79490

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ALL APPEALS MUST BE IN WRITING
Please MAIL WRITTEN APPEALS (ONLY) to:
InsuranceTPA.com
14 N. Parker Drive
Janesville, WI 53546