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At Mountain States we are on a Mission:

"To satisfy our clients needs and expectations through the development of quality plans, while delivering exceptional customer service by exceptional employees."
* Medical Corner

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Find a Doctor
Click here to find a listing of PPO Network websites.

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MSAS Medical Forms

Please click on the form type below to view.

* fill out and email to Mountain States

  • Accident Letter*
  • Dental Claim Form
  • HRA Claim Form
  • Medical Claim Form (HCFA 1500)
  • MSAS Patient Information Form
  • Other Insurance Coverage Letter*
  • Pre-Existing Condition Letter and Form*
  • Subrogation Letter*
  • Vision Claim Form

    Click here to download Adobe Acrobat Reader


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    Pharmacy Websites
    Click here to find a listing of Pharmacy websites.

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    MyMSAS online may allow clients to view:
  • Claims Information
  • Coverage Verification
  • Flexible Spending Account Balances

    • MyMSAS Online Registration Instructions

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    Benefit Informatics


    		  

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