Advisory 2000-05B

Revised Forms Effective Date

Although TWCC encourages the immediate use of the following revised forms and instruction sheets, the following will be required effective February 1, 2001:

TWCC-60(A|B), Medical Dispute Resolution Request/Response

TWCC-62, Explanation of Benefits

TWCC-67, Instructions for Completing the HCFA-1500

TWCC-68, Instructions for Completing the UB-92

TWCC-48, Request for Travel Reimbursement

These forms and instructions are available on our Web page at and may be downloaded and copied.

Signed this 29^th day of August, 2000

_______________________________
Leonard W. Riley, Executive Director

 Distribution:

TWCC Staff
Public Information List
Commission Representatives
Professional Medical Associations

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