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 - CONTINUATION OF SHORT TERM DISABILITY
07/07/2020 - 0.20MB
USE THIS FORM TO CONTINUE YOUR SHORT TERM DISABILITY BENEFITS.

BLUE CROSS/BLUE SHIELD - CLAIM FORM
07/25/2019 - 0.51MB

CENTRAL STATES PENSION - DIRECT DEPOSIT
06/20/2018 - 0.11MB

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.

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.