WAGEWORKS CARD USE VERIFICATION FORM PDF

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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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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 system, 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.

Keep in mind that if an insurance payment was made, this information must be included on the documentation you send. Service Description — Detailed description for services provided.

Please don’t use a highlighter on anything verifcation send to us wagewirks it usually makes the information unreadable when faxed.

Click here for your FSA Worksheet. If documentation for the actual transaction is not available, you may submit substitute documentation for any eligible purchase. The amount of any outstanding unverified Card transactions may be deducted from your next Pay Me Back claim submission. Carrd receipts, EOBs and other supporting documentation. You have 90 days from the date of the transaction to take care of any outstanding unverified purchases.

For more information on eligible cars go to: Please keep the following tips in mind when sending a fax. Log on to your account at www. Before shopping for prescriptions and OTC items, always visit www. The fax number, email address and mailing address are listed at the top of the form.

You can choose from two accounts: 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 verlfication your account for the amount of the unverified transaction.

WageWorks Web Tutorial: WageWorks Card Use Verification Form

The amount of your check will be added back into your account as an adjustment for the unverified transaction and be available for other eligible health care purchases.

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Now, let’s discuss the types of documentation that may be sent in to take care of Card Use Verification Requests. Within five business days, WageWorks will process your request and mail your reimbursement check to you or direct deposit your funds into the account of your choice. An eligible child uuse divorced parents is treated as a dependent of both, so either or both parents can establish a Health Care FSA.

If you use the Card at a health care provider or at a pharmacy that does not have an IIAS system, WageWorks will likely require that you submit a receipt or your health insurance explanation wageworkx benefits EOB to verify that the transaction was for an eligible health care verificatioon or service.

Follow the step-by-step instructions provided to upload and submit your claim. 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.

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. 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. Quick Tips About the Card Log on to your account at www.

You will be responsible for any charges until you report the lost Card. Make Sure Your Receipts Meet Requirements for Verification In order for the receipt or any documentation to be valid, it must include the five specific pieces of information required by the IRS: To accept the Card, the merchant must have an IRS-qualified system that can automatically verify transactions at checkout. Dates of Service — Service start and end date for services provided. You can check your account online at any time to review the status of your Card Use Verification.

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.

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You are, however, required to keep each receipt for tax purposes, and in the event it is needed for verification. The type or description of the service or product. 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 speed processing, remember to save receipts that show exactly what you paid for, the amount and date of service.

For each transaction that’s listed, be sure you mark whether you’re sending the actual documentation.

Let’s begin dard completing the form. 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 account when a Card transaction is in need of verification. Examples of how to use your FSA: Dependent Name — Person who received the service.

I want to learn more about Unlike a Medical Expense FSA, the entire maximum annual amount is not wageowrks during the plan year, but rather after your payroll deductions are received. Please make sure the documentation includes the following five pieces of information.

If you have lost or misplaced the receipt, you can submit a substitute receipt of equivalent value or repay your account. When you pay for an wgeworks health care or dependent care expense, you want to put your FSA fogm to work right away.

With either FSA, you benefit from having less taxable income in each of your paychecks, which means more spendable income to use toward your eligible medical and dependent care expenses. 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 by your insurance.

If you lose your Card, please call WageWorks immediately to report your csrd Card and order a new one. Online Claims You can file a claim online to request reimbursement for your eligible expenses. For tips and more information about how evrification use your Card please visit www. In order for the receipt or any documentation to be valid, it must include the five specific pieces of information required by the IRS:.