Case management - form completion team
We can 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.
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 10 to 14 business days. This process may be delayed if your treating health care provider is out of the office, on vacation, in surgery, etc. Please contact your treating health care providers office for any questions on the status of forms. Forms can be faxed to the case management team directly at (920) 272-1084 or email PRV-CaseManager@prevea.com.
Medical records
If you need copies of your medical records, call Prevea record release at (920) 496-4783 or click here for more information.
For employers
To review your company–specific needs or to learn about other corporate services, click here.