Prepare bankruptcy claims and complete related forms. Insurance companies can utilize this letter template to seek reimbursement from the person or entity legally responsible for a loss.Apply to Claims Adjuster, Adjuster, Senior Claims Representative and more! Individuals can report alleged wrongdoing on the part of Broward County, its officers, employees, and independent contractors,. The Plaintiff, above named, complaining of Defendants, above named, alleges and says as follows: 1. Submit application to The Office of the State Attorney, 17th. Subacute Care Med Advantage: 813-806-1277; Out of State Residents: 904-357-6087. Note: include your authorization number on the medical records being faxed. Fill out the below form or contact us at 1-866-796-0530. Your inquiry will be reviewed.