Get Teamcare HW8AA 2016
Ad and print the claim form from the TeamCare website at MyTeamCare.org or you can call 800-TEAMCARE to request a claim form be mailed or faxed. COMPLETING CLAIM FORM: Part 1: Must be completed by the employee Part 2: Must be completed by your treating physician Part 3: Must be completed by your Employer/HR Department SUBMITTING CLAIM FORM: Once the claim form is completed, you can either mail or fax claim to: MAIL: TeamCare – Central States Health Fund PO Box 5107 Des Plaines, IL 60017-5107 F.
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