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  • DOCUMENTS


    Order By: [Date] [Name] [Descendant]

    BLUE CROSS/BLUE SHIELD - CLAIM FORM
    07/25/2019 - 0.51MB
    CENTRAL STATES PENSION - DIRECT DEPOSIT
    06/20/2018 - 0.11MB
    TEAMCARE - APPEALS FORM
    06/19/2018 - 0.04MB
    IF YOU ARE NOT SATISFIED WITH TEAMCARE'S DECISION ON A CLAIM, SUBMIT THIS FORM TO REQUEST A REVIEW.
    TEAMCARE - CONTINUATION OF SHORT TERM DISABILITY
    07/07/2020 - 0.20MB
    USE THIS FORM TO CONTINUE YOUR SHORT TERM DISABILITY BENEFITS.
    TEAMCARE - INITIAL OF SHORT TERM DISABILITY
    07/07/2020 - 0.42MB
    USE THIS FORM TO INITIATE YOUR SHORT TERM DISABILITY BENEFITS FOR NON-WORK RELATED INJURIES OR ILLNESSES.
    TEAMCARE - PREDETERMINATION OF BENEFITS FORM
    06/20/2018 - 1.38MB
    SUBMIT THIS FORM AHEAD OF TIME TO DETERMINE IF YOUR MEDICAL PROCEDURE WILL BE COVERED BY TEAMCARE.

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