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Click here for our 'Authorization for Access/Use/Disclosure of Protected Health Information (PHI)' form.
If you are having trouble here is a handy portal user guide.
FAX: If you cannot use the online portal (or do not have your forms in a PDF) complete the Request for Form Completion and include all of your forms like FMLA, Disability, Accidental claim form(s) and FAX to: 866-570-0729.
For each consecutive or subsequent FMLA or Disability form regarding the same qualifying condition and claim, a $15 fee will be assessed.
If I need another form completed to continue my disability claim, will I have to make another payment?
Yes, a fee of $15 per form plus any applicable sales tax for each consecutive or subsequent FMLA or Disability form will be charged as long as the form is regarding the same qualifying condition and claim.
How can I pay for the forms?
Preferred and fastest method: Pay Online! You will receive an email notification from Sharecare 2-3 business days after you have submitted your form. The e-mail will include a payment link that will direct you to pay on the Sharecare payment portal website at payonline.sharecare.com
You will be required to enter the invoice ID/request ID on the payment website. The invoice/Request ID appears on the billing notification e-mail and on any other e-mail notifications you receive from Sharecare.
You will simply need to enter your date of birth, first and last name, and then click “search” to view all requests that you have submitted to Sharecare and their status.
You can also 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.
**Please allow 2 business days after your submission before attempting to track your request. You may also see other requests populate from prior form(s) submissions or from other entities like third-party requesters. Please note the date and the zip code of delivery provided, should there be multiple results.**
If you still need assistance, please reach out to our team at Sharecare, and we are happy to discuss: 866-273-4039.
Sharecare Health Data Services (HDS) is a health data forms completion company. They have partnered with our company to assist patients in processing their FMLA and/or Disability form(s). There is a processing fee that we will need to obtain to begin completing your form.
Please allow 48 hours for a Sharecare representative to receive your form and contact you for payment from the time you submit it. Please allow 5-7 business days for the processing of the forms.