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FMLA/Disability Forms


 
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Orthopaedic Associates has partnered with Sharecare to fulfill your requests for records.

We are committed to protecting your medical information. For information about your rights and the obligations you have regarding the use and disclosure of your medical information, please see our Notice of Privacy Practices.

FMLA/Disability Submission for Patients and Requesters

If you are a patient, employer, or disability company requesting an FMLA or Disability form to be completed, please click on the button below to upload your blank form.

Once you have submitted your form, Sharecare will contact you within 48 hours to collect payment for processing.

Disability FMLA Request Submission

This is for patients, disability companies, or employers to submit their FMLA or Disability form to Sharecare for completion


FMLA/Disability Requests


Form Completion Process FAQ

The FAQ below will help guide you through your FMLA/Disability or accident claim.

What is Sharecare, and what exactly do they do?
Sharecare is a health information management company contracted with Orthopaedic Associates to provide services, including the completion of Disability and FMLA form paperwork.

How do I submit my FMLA or Disability paperwork?

  • Submit the form to Sharecare using the FMLA/Disability Request button above
  • Fax the form to: 866-572-0549

Is there a fee to have my forms completed?
Yes, there is a pre-payment fee of $35 for the first form.

If I need another form completed to continue my disability claim, will I have to make another payment?
Yes, a pre-payment fee of $35 is needed for each consecutive or subsequent FMLA or Disability form regarding the same qualifying condition and claim.

How can I pay for my forms?
There are various ways to pay for your form:
Pay Online:

    • If you provide a valid email address on your authorization form, you will receive an email notification with a payment link that will direct you to pay on the Sharecare payment portal website.
    • If you do not provide an email address on your authorization form or cannot locate the email notification, you can pay online at payonline.hds.sharecare.com. You will need your Request ID to make the payment.

Pay by Phone:
    • Contact the Sharecare Forms Department at 866-273-4039. We like to make it as easy and convenient as possible for you. We accept all major credit cards and HSA cards as a payment method.

What is a Request ID?
A Request ID is a unique ID specific to the individual patient and form being completed. Sharecare assigns the ID, and if you are unable to locate it, you can contact Sharecare for assistance at 866- 273-4039.

Do I need to sign an authorization form even if I want the form sent back to me?
Yes, we would like all the patients to fill out a Request for Form Completion document when requesting a form to be completed. This document provides the team with information on where and how to send the form. Also, if a disability insurance company calls, we cannot give any information without consent, thus delaying your claim with your disability company. In addition, this document asks for the patient to identify the treating provider, injury/problem date, and last day worked, which will aid in completing your form.

I do not use email or know my Request ID number. How can I get status updates on the completion of my form?
You can contact the Sharecare Forms Department at 866-273-4039 for the status of your form, as well as the Request ID number associated with your form.

I need to update the information on my FMLA or Disability paperwork. What do I need to do?
We understand that FMLA forms, as well as disability determinations, may require an update of your medical information from your recent doctors' visit. You will need to re-submit the new paperwork to Sharecare to complete in such cases. There will be a fee of $35.00 required for any updates requested.

When will I receive my completed forms?
Please allow 48 hours for Sharecare to process your request. Once payment is received, it may take up to 5-7 business days to complete the forms. It is imperative to submit all information and make the pre-payment as soon as possible; failure to do so will delay the process.

I submitted my paperwork but no longer need it to be completed. How can I cancel it?
You can contact the Sharecare Forms Department at 866-273-4039 for assistance.

I still have questions?
Please reach out to our team at Sharecare, and we are happy to discuss any questions you might have. Contact us at 866-273-4039

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