WAGEWORKS CARD USE VERIFICATION FORM PDF

Completing the Card Use Verification Form Now that you know how you are going to resolve your transaction(s), it’s simple to complete the form. Check the box. The Card Use Verification form is available on the WageWorks Web site when you log into your account. A link titled ‘Submit Receipts for Health Care Card Use’ . is new for and enables merchants to verify eligible purchases at the register When you use your Card for an eligible item or service, the money is taken Use another form of payment and submit receipts for reimbursement via Pay.

Author: Kagazshura Mecage
Country: Bahrain
Language: English (Spanish)
Genre: Automotive
Published (Last): 26 December 2005
Pages: 433
PDF File Size: 2.52 Mb
ePub File Size: 3.62 Mb
ISBN: 593-6-85034-959-7
Downloads: 16108
Price: Free* [*Free Regsitration Required]
Uploader: Sharisar

Only the custodial parent of divorced or wagwworks parents can be reimbursed using the Dependent Care FSA. The type or description of the service or product.

Keep in mind that if an insurance payment was made, this information must be included on the documentation you send. The amount of your check verificatio be added back into your account as an adjustment for the unverified transaction and be available for other eligible health care purchases. Quick Tips About the Card Log on to your account at www. The Card Wageworka Verification form should be the first sheet of your fax, please don’t use a cover-page.

Unlike a Medical Expense FSA, the entire maximum annual amount is not available during the plan year, but rather after your payroll deductions are received. Your request will be processed within five business days and either mailed to you or deposited into the account you have chosen. If documentation for the actual transaction is not available, you may submit substitute documentation for any eligible purchase.

If you do not take action within 90 days: To speed processing, remember to save receipts that show exactly what you paid for, the amount and date of service. Dates of Service — Service start and end date for services provided. You may use your Dependent Care FSA to receive reimbursement for eligible dependent care expenses for qualifying individuals.

Read Also:  LA PERMACULTURE DE SEPP HOLZER EPUB

You will be responsible for any charges until you report the lost Card. For each transaction that’s listed, be sure you mark whether you’re sending the actual documentation, a substitute receipt or a check to repay the account. Second, the provider name. If you have a Card transaction that requires verification, you will be notified immediately on the Welcome page upon login and via email. Scan receipts, EOBs and other supporting documentation. Wagesorks you prefer to submit a paper claim by fax or mail, you can go to www.

Please don’t use a highlighter on anything you send to us as it usually makes the information unreadable when faxed. Log on to your account at www. While many of your Card transactions will be verified at checkout, you still will need to hold on to your receipts for tax purposes and in case we need to verify the transaction for any reason. In most instances, your Card transaction will be verified at checkout, which means you will not have to submit a receipt to WageWorks after the transaction.

If documentation for the actual transaction is not available, you may submit substitute documentation for any eligible wageworjs that was not made with your WageWorks Health Care Card or filed as a Pay Me Back claim.

If you pay for eligible recurring expenses, follow the online instructions to set up automatic payments.

WageWorks Web Tutorial: WageWorks Card Use Verification Form

Before shopping for prescriptions and OTC items, always visit www. Third, the date of service or the purchase. How to Use Your Card at the Doctor If you use the Card at a health care provider or at a pharmacy that does not have an IIAS dorm, WageWorks will likely require that you submit a receipt or your health insurance explanation of benefits EOB to verify that the transaction was for an eligible health care expense or service.

Read Also:  ANSI B18.22.1 DOWNLOAD

A great example of documentation that’s acceptable is the insurance company’s explanation of benefits form. For more information on eligible expenses go to: Even when your Card is approved, a detailed receipt may still be requested; you will be notified by email and when you log into your wageworke when a Card transaction is in need of verification. Log in to your FSA account at www. Click here for your FSA Worksheet. If you don’t have the documentation or a substitute receipt, this might be a good option for you.

Submit these documents, along with a claim form to WageWorks. If you lose your Card, please call WageWorks immediately to report your missing Card and order a new one. In order for the receipt or any documentation to be valid, it must include the five specific pieces of information required by the IRS:.

You still will be able to use the Card to purchase certain medical items, such as band-aids, at qualified merchants. You also have the option to send in check to repay your account verirication the amount of the unverified transaction.

Use your WageWorks Health Care Card ues of cash or credit at health care providers and pharmacies for eligible services, goods and prescriptions. You have the option to fax, email or mail in the Card Use Verification Form.