Transmitting Claims Via Fax

As always you can submit your claims to First Source by simply filling out a claim fax cover sheet. Below you will find a blank form for your use. However, we recommend that you contact First Source prior to submission.

Click here to download the fax cover sheet.



   








   




First Source is HIPAA Compliant
© 2010  First Source           Phone: (602) 410-7407     Fax: (866) 358-7444