Submit a Bill

To submit a medical or hospital bill, please select the Request Form link below, print out the "Request for Medical Cost Management Services" form, fill it out completely, then fax it, along with the patient/claimant's medical bill(s) to 281-350-5772. A PMS auditor will contact you once we receive the documents.

If you have any questions or incur any technical problems, please contact us at our telephone listed below or via the Contact Us page.

  Request Form