As you may know, the HIP MCEs do not recognize the FSSA AR form.  Each of the HIP MCEs require its own form to be submitted in order for anyone to communicate with them on behalf of the member.  If necessary, please use the forms below and fax to the appropriate number.

Anthem AR Form

Fax: 866.464.9957


MDwise AR Form

Fax: 877.822.7190



Fax: 866.912.1629