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.

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Log in to your FSA account at www. If you have lost or misplaced the receipt, you can submit a substitute receipt of equivalent value or repay your account. 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.

Pay for services or purchases on the same day you receive them. Also, don’t forget to complete the dollar amount.

I want to learn more about Follow the step-by-step instructions provided to upload and submit your claim. First, the patient name, this may be excluded for over the counter items. Your Health Care FSA may be used to reimburse eligible expenses incurred by yourself, your spouse, your qualifying child or your qualifying relative. And remember it takes us two business days for ise form to be processed and reviewed.

For more information on eligible expenses go to: Use your WageWorks Health Care Card instead of cash or credit at health care providers and pharmacies for eligible services, goods and prescriptions. Click here for your FSA Worksheet. The fax number, email address and mailing address are listed at the waggeworks of the form.

WageWorks Web Tutorial: WageWorks Card Use Verification Form

If you don’t have the documentation or a substitute receipt, this might be a good option for you. Please don’t use a highlighter on anything you send to us as it usually makes the information unreadable when faxed.

You can choose from two accounts: In wagewkrks for the receipt or any documentation to be valid, it must include the five specific pieces of information required by the IRS:.

If not included, a copy of the prescription must accompany the receipt instead. If you lose your Card, please call WageWorks immediately to report your missing Card and order a new one.

Once you sign up for a Dependent Care FSA and decide how much to contribute, the funds available to you depend on the actual funds in your account. Not only are your Medical Expense FSA funds available to you in one lump sum at the beginning of your plan year, but your FSA funds are deducted before federal and state taxes are calculated on your paycheck.

For eligible goods and services at health care providers and select pharmacies For eligible Over-the-Counter OTC non-drug items at general merchandise stores including most drugstores that have an industry standard IIAS inventory and checkout system For prescribed OTC drugs at the pharmacy counter, as long as the drug is dispensed as a valid prescription Go to www. Examples of how to use your FSA: If you do not take action within 90 days:.

Once you sign up for a Medical Expense FSA and decide how much to contribute, the maximum annual amount of reimbursement for eligible health care expenses will be available throughout your period of coverage. WageWorks gives you several options to use your money the way you choose. If you have a Card transaction that requires verification, you will be notified immediately on the Welcome page upon login and via email.

The Card Use Verification form should be the first sheet of your fax, please don’t use a cover-page. For tips and more information about how to use your Card please visit www. Please keep the following tips in mind when sending a fax. The type or description of the service or product, and finally the amount of patient responsibility.

Now, wgeworks discuss the types of documentation that may be sent in to take care of Card Use Verification Requests. The amount of your check will be added back into your account as an adjustment for the unverified transaction and be available verificxtion other eligible health care purchases. You still will be able to use the Card to purchase certain ferification items, such as band-aids, at qualified merchants.

Scan receipts, EOBs and other supporting documentation. A Flexible Spending Account FSA is an account you set up to pre-fund your anticipated, eligible medical services, medical supplies and dependent care expenses that are normally not covered usd your insurance.

Second, the provider name. Remember to also monitor the Statement of Activity page for pending transactions, as it can take up to three weeks to verify a purchase.

To accept the Card, the merchant must have an IRS-qualified system that can automatically verify transactions at checkout. To speed processing, remember to save receipts that show exactly what you paid for, the amount and date of service. If documentation for the actual transaction is not available, you may submit substitute documentation for any eligible purchase.