
HEALTH CARE PROVIDER CERTIFICATION Family and Medical Leave PD 615A This Form is Used to Provide Certification Per FMLA and OFLA


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People also ask
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Who can fill out FMLA paperwork in Oregon?
This form is to be completed by physician or other health care provider and returned to: ☐ the employee, or ☐ the employer (below): Information sought on this form relates only to the condition for which the employee is taking leave.
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What is a health care provider certification?
The purpose of certification of health care provider is to signNow those employees on medical leave who otherwise do not qualify for or have exhausted all time off under the Family and Medical Leave Act (FMLA).
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What is the CPT code for FMLA?
If the patient comes into the office to have FMLA paperwork filled out, you would use CPT code(s) 99455 or 99456 with the ICD-9-CM code of V68.
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What is WH 380 F?
WH-380-F (Certification of Health Care Provider for Family Member's Serious Health Condition)
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