Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Managed Health Services Indiana (MHS Indiana) before sending sensitive documents. FaxFlow is not affiliated with this organization.
Managed Health Services Indiana (MHS Indiana) fax number
(866) 912-1629
Member Services
Used for: Submission of member-related forms and communications; commonly used for disenrollment requests and other member-service communications.
Fax destination details
- Department
- Member Services
- Purpose
- Submission of member-related forms and communications; commonly used for disenrollment requests and other member-service communications.
- Form
- Disenrollment form — Request for Member Disenrollment Form
- Address
- 1099 N. Meridian Street, Suite 400, Indianapolis, IN 46204
- Voice phone
- 1-877-647-4848
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Fax the completed disenrollment form to MHS Member Services at 1-866-912-1629.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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