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Prevea Health’s case management team can assist you with navigation of the healthcare system while you are off work recovering from your serious health condition.
We can also assist your treating healthcare provider with any paperwork that needs to be completed for your time away from work under short-term disability, family medical leave or workers’ compensation.
Here are some common questions and answers to help you through this process:
What is a case manager?
A case manager is a liaison among patient, employer, insurance carrier and treating health care provider.
What does a case manager do?
Serves as a contact for patients, employers, insurance carriers dealing with workers’ compensation, disability and family leave claims.
Completes workers’ compensation, disability, Family Medical Leave Act (FMLA) forms on behalf of the treating health care provider.
What do I need to do for workers’ compensation?
First, if you are injured at work, it is your responsibility to notify your employer immediately when it occurs.
Information related to your work comp injury will be requested at the time of your evaluation at Prevea Health. Notify the receptionist when you check in for your appointment that you are filing a claim under workers’ compensation.
Ask for a return to work slip at every office visit related to the injury—your employer and workers’ compensation carrier will require this. Most employers will find work for you within any limitations or restrictions provided by your health care provider.
If you need forms signed by your doctor, drop them off at any Prevea location and fill out an authorization for disclosure of health information form available on this page. This form must be completed and signed by the patient in order for Prevea to send the forms to any third party (insurance carriers, attorney, etc.)
As with other types of insurance, we will submit claims to the workers compensation carrier. If it is determined that your injury is not covered under workers compensation, we will bill your personal health insurance. If you do not have health insurance coverage, the charges related to the care provided will be your responsibility.
What do I need to do for short-term disability, long-term disability and FMLA?
If your employer offers coverage under short term, long term or FMLA, paperwork is required to file a claim and must be obtained from your employer.
Ask for a return to work slip at every office visit related to the claim—your employer and insurance carrier will require this.
If you need forms signed by your doctor, drop them off at any Prevea location. You will need to complete and sign an Authorization for Disclosure of Health Information Form. This form must be filled in completely in order for Prevea to release the information to anyone other than the patient. Fully reflect on the form who to forward the information to and what specific information should be sent.
In order for Prevea to respond to any requests to information from your employer or disability carrier an Authorization for Disclosure of Health Information form must completed and on file. This form indicates your permission for Prevea to share information with your employer or disability carrier.
*Standard form completion process is 7 to 10 business days. This process may be delayed if your treating health care provider is out of the office, on vacation, in surgery, etc.
Case management for contracted employers
In addition, Prevea provides these short-term disability case management services to our contracted employers:
• Track all employee lost time requests and claims once coverage/eligibility is determined by employer
• Monitor employee’s progress through collaboration with the employee and health care provider
• Ongoing communications with employer contact and employee
• Return to work coordination
• Comprehensive case management utilizing lost time tracking against national disability durations
• Assist patient with navigation of health care system providing guidance to obtain the right care at right timeprevea.com
To review your company–specific needs or to learn about other services, contact:
Shelly Tatro, RN, CCM, CLNC
Manager Work Comp Employer Relations
If you need copies of your medical records, call Prevea Record Release at (920) 496-4783 or fax a request and a release authorization to (920) 496-4737.
Contact your doctor’s office directly if you:
Need a return to work slip
Need a return to work slip changed
Have questions regarding prescription medications and/or prescription refills
Have questions regarding your treatment and/or referrals
Please fill out a release authorization form prior to treatment. Click here to download the release authorization form if your treating provider is located at a St. Clare/Prevea Health site.
Medical Release Form English
Medical Release Form Hmong
Medical Release Form Spanish
Medical Release Form Somali
For all other Prevea Health providers and locations, click here.