800-944-0859 or 409-384-5444

FORMS

The TDI requires all reports to be submitted on their most current forms. Please check back regularly to verify that you are using the most current forms available. These forms require Microsoft Word and can be printed and mailed or e-mailed.

E-mail all forms to claims@detsif.com.

mwoods@detsif.com

karen.mcclellan@tristargroup.net

jason.cutler@tristargroup.net

Please email claims to all 4 email addresses.

Note Tristar will assign a claim number and adjuster.

If this is after hours and you need a prescription filled please use this card.

Claim Forms

*You can still access the downloadable Word Doc files by clicking the link on form name.

Instructions:

1. Download and save the forms to your computer.

2. Fill out the repetitious information and save the form again.

3. Filling out a form is a simple “type and tab” process. After completing a form, print and sign a copy for your files. You may also save the form to your computer.

4. E-mail the form to claims@detsif.com or FAX the form to (409) 384-7953. To e-mail do a “file, send to, mail recipient (as attachment)”.

5. We acknowledge receipt of all e-mailed forms by return e-mail. If you do not get a response from us you can assume that the form was not received.

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