This activity has three steps:

         1. Read the scenario.
         2. Print the claim form information.
         3. Choose whether you would like to be prompted by the tutorial or complete this activity on your own.

Scenario: Joseph A. Miller had gastric bypass surgery. He was diagnosed on January 10, 2007, and the procedure was performed on March 1, 2007. He was hospitalized for four days and did not need any outside lab work. You also have an approved Treatment Authorization Request (TAR) for this procedure.

Click to print the claim form information.

Choose how you would like to start your activity:

I want the tutorial to prompt me where
to put the claim form information.

I want to fill out the claim form on my own.