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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Your request will be processed within five business days and either mailed to you or deposited into the account you have chosen.

If you do not take action within 90 days:. Most claims are processed within one to two business days after they are received, and payments are sent shortly thereafter. If you lose your Card, please call WageWorks immediately to report wagewor,s missing Card and order a new one. Please keep the following tips in mind when sending a fax.

While your WageWorks Health Care Card and account offer a great deal of convenience, both are regulated by IRS rules that all participants are required to follow.

How to Verify a Card Transaction If WageWorks is unable to determine that your Card was used to pay for eligible health care products and services, you will need to take the following action to verify the transaction: You will be responsible for any charges until you report the lost Card.

The amount of any outstanding unverified Card transactions may be deducted from your next Pay Me Back claim submission.

You have the option to fax, email or mail in the Card Use Verification Form. Click here for your FSA Worksheet.

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WageWorks Web Tutorial: WageWorks Card Use Verification Form

If you do not take action within 90 days: Scan receipts, EOBs and other supporting documentation. I want to learn more about Remember to also monitor the Statement of Activity page for pending transactions, as it can take up to three weeks to verify a purchase.

Only the custodial parent of divorced or legally-separated parents can be reimbursed using the Dependent Care FSA. 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.

If documentation for the actual transaction is not available, you may submit substitute documentation for any eligible purchase that was not made with your WageWorks Health Care Card wgeworks filed as a Pay Me Back claim. To pay a provider: You have 90 days from the date of the transaction to take care of any outstanding unverified purchases. You may submit the actual documentation for the transaction listed. Substitute documentation must also have the same five pieces ferification information we just reviewed.

You still will be able to use the Card to purchase certain medical items, such as band-aids, at qualified merchants. Log in to your FSA account at www. 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 wabeworks 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.

If your Card is suspended, it will be reactivated within 24 — 48 hours after receipts or veridication have been processed for all unverified Card transactions.

If you have lost or misplaced the receipt, you can submit a substitute receipt of equivalent value or repay your account. The fax number, email address and mailing address are listed at the top of the form.

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For tips and more information about how to use your Card please visit www. The form does not need to be signed or dated. Amount — The amount incurred for the services. 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: 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.

And remember it takes us two business days for your form to be processed and reviewed. In order for the receipt or any documentation to be valid, it must include the five specific pieces of information required by the IRS:.

While many of your Card transactions will be verified at checkout, you still will need usw hold on to your receipts for tax purposes and in veriifcation we need to verify the transaction for any reason. Follow the step-by-step instructions provided to upload and submit your claim. If WageWorks is unable to determine that your Card was used to pay for eligible health care products and services, you will need to take the following action to verify the transaction:.

If documentation for the actual transaction is not available, you may submit substitute documentation for any eligible purchase.