Disability Claims 

If you are applying for Short-Term or Long-Term Disability, our office can assist you with completing the necessary paperwork. Your request will be processed by our Health Information Management Department.

• All disability paperwork from the company that handles your disability leave must be sent to Northwest Primary Care. Patients should complete any portions labelled for the claimant. Patient name and Date of Birth should be included on all forms.
• A signed Authorization to Release Medical Information (ARMI/ROI) must be included with all paperwork. This authorization must be on file for your current claim or Northwest Primary Care will not submit completed paperwork or medical records to your disability leave company. If you do not have a release form, you can fill out one here >
  • Contact information for your disability leave company must be included either on the ARMI/ROI or your disability paperwork.
• Your provider may require an appointment to complete paperwork. If this is a new claim, your provider will likely want to discuss the paperwork and complete it with you in office. A member of your clinical care team will contact you after we have received your paperwork if you do not have an appointment.

How to send your paperwork to NWPC

• Patient Portal. Your patient portal is the fastest and easiest way to submit your paperwork to us. To send paperwork, please go to your “Inbox/Messages” section, create your message, and attach a copy of your paperwork using the paperclip symbol in the attachment section.
• Fax: Attn Health Information Management, 833-428-6205
• Mail: Northwest Primary Care Health Information Management
  PO Box 22075
  Milwaukie, OR 97269
• In Person: You can drop off paperwork with the front desk staff at any of our clinical locations.

What to Expect Once Paperwork has been submitted to Northwest Primary Care
Our Health Information Management department will process your disability paperwork and work with your provider to ensure all necessary information to process your claim request(s) are submitted to the company that handles your disability paperwork.

Once completed, if there is a valid authorization on file, our Health Information Management department will submit your disability paperwork.  An electronic copy of the completed paperwork will be sent to you via your NWPC Patient Portal. If you do not have a NWPC Patient Portal a copy will be mailed to you.

FMLA (Family Medical Leave) Claims

• All FMLA paperwork from the company that handles your FMLA leave/Employer must be sent to Northwest Primary Care. Patients should complete any portions labelled for the claimant. Patient name and Date of Birth should be included on all forms.
• Your provider may require an appointment to complete paperwork. If this is a new claim, your provider will likely want to discuss the paperwork and complete it with you in office. A member of your clinical team will contact you after we have received your paperwork if you do not have an appointment.
• Northwest Primary Care does not submit FMLA forms. It is the patient’s responsibility to submit completed paperwork.

How to send your paperwork to NWPC

• Patient Portal. Your patient portal is the fastest and easiest way to submit your paperwork to us. To send paperwork, please go to your “Inbox/Messages” section, create your message, and attach a copy of your paperwork using the paperclip symbol in the attachment section.
• Fax: Attn Health Information Management, 833-428-6205
• Mail: Northwest Primary Care Health Information Management
  O. Box 22075
  Milwaukie, OR 97269
• In Person: You can drop off paperwork with the front desk staff at any of our clinical locations.

What to Expect Once Paperwork has been submitted to Northwest Primary Care
Our Health Information Management department will process your form, and the completed paperwork will be returned to you. A member of your clinical team will contact you once paperwork is completed.

Paid Leave Oregon Claims

If you are applying for Paid Leave Oregon (PLO), our office can assist you with completing the necessary paperwork. Your request will be processed by our Health Information Management Department

• All Paid Leave Oregon must be sent to Northwest Primary Care. Patients are responsible for sending all PLO paperwork that is needed to NWPC.
• Your provider may require an appointment to complete paperwork. If this is a new claim, your provider will likely want to discuss the paperwork and complete it with you in office. A member of your clinical care team will contact you after we have received your paperwork if you do not have an appointment.
• Northwest Primary Care does not submit any PLO paperwork. This is the responsibility of the patient.

How to send your paperwork to NWPC

• Patient Portal. Your patient portal is the fastest and easiest way to submit your paperwork to us. To send paperwork, please go to your “Inbox/Messages” section, create your message, and attach a copy of your paperwork using the paperclip symbol in the attachment section.
• Fax: Attn Health Information Management, 833-428-6205
• Mail: Northwest Primary Care Health Information Management
  O. Box 22075
  Milwaukie, OR 97269
• In Person: You can drop off paperwork with the front desk staff at any of our clinical locations.

What to Expect Once Paperwork has been submitted to Northwest Primary Care
Our Health Information Management department will process your form, and the completed paperwork will be returned to you. A member of your clinical team will contact you once paperwork is completed.

Privacy and Confidentiality

Protecting your privacy is important to us. When you become a Northwest Primary Care patient, we will ask you to review our Notice of Privacy Practices, which explains:

• How Northwest Primary Care may use and share your health information
• Our responsibilities to protect the privacy of your information
• Your rights and choices related to your health information

You can always access our Notice of Privacy Practices here >

How We Help Protect Patient Privacy

We take steps across our clinics, systems, and workforce to help safeguard your health information and respect your privacy.

• Training and confidentiality standards for our workforce
• Limiting access and sharing to what’s needed for care, operations, or as required by law
• Private conversations when possible and respectful care practices
• Transparency about visitors/observers, with the option to request nonessential observers leave when feasible
• Secure medical records with role-based access for authorized staff
• No sharing with family or others without your permission, except as permitted or required by law

Your information is also protected by federal and state privacy laws, including HIPAA (the Health Insurance Portability and Accountability Act).