Division of Immigration Health Services

Managed Care

Benefits Package

Detention Facilities

Detention Facility Formulary

Contacts

Forms

TARWeb

Current National Threat Level is elevated

The threat level in the airline sector is High or Orange.

Forms

The following forms are provided by the Managed Care Services Unit.

TARWeb Account [MS Word] NEW FORM

TARWeb Account [PDF] NEW FORM

TAR Form [PDF] (When TARWeb is unavailable)

CMS-1500 Form

CMS-1500 Instructions

CMS-1450 Form

CMS-1450 Instructions

ADA Form

ADA Instructions

Claims, Billing and Payment:

Division of Immigration Health Services
VA Financial Services center
PO Box 149345
Austin, Tx 78714-9345
800-479-0523