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2019 Teamcare Application for Extension of Coverage

2019 Teamcare Application for Extension of Coverage-2025

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4.8 out of 5

75 votes

The document is an application form for an extension of medical coverage, requiring completion by both the participant and their physician. It outlines eligibility criteria, including total disability due to a specific medical condition, and mentions alternative options like COBRA self-payments. The form collects personal information, insurance details, and requires verification from the participant's spouse's employer if applicable. Additionally, it mandates a physician's assessment of the disabling condition to process the request.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (75 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Which insurance is available in case you are unable to work for an extended period of time ?

Disability insurance pays part of your income if you get sick or have a physical or mental disability that keeps you from working. The amount you get paid is usually a percentage of your pay.

What is the phone number for TeamCare disability?

For additional questions, contact TeamCare through your Message Center, or by calling us at 1-800-TEAMCARE (1-800-832-6227).

What is the timely filing limit?

Network Health will only accept written claims submitted in the English language. When Network Health is the secondary payer, claims must be submitted to Network Health within 90 days after the date of processing listed on the primary payers Remittance Advice, or as specified in your Provider Contract.

Who runs TeamCare?

The Central States Southeast and Southwest Areas Health and Welfare Fund was founded in 1950 and was one of the first non-profit labor health funds in the United States. Since 2014, the Fund has done business under the tradename TeamCare.

What is the timely filing limit for TeamCare?

How long do I have to file a claim? Unless your network contract states otherwise, there is a 12-month filing limit on claims.

What is the timely filing limit for health Alliance?

Providers have 90 days from the date of service to submit claims(original claim submission). Providers have 365 days from the remit date to submit a corrected claim.

2019 Teamcare Application for Extension of Coverage-2025

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