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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Quick Tips About the Card Log on to your account at www. If documentation for the actual transaction is not available, you may submit substitute documentation for any eligible purchase that was not made with wagewoks WageWorks Health Care Card or filed as a Pay Me Back claim.

First, the patient name, this may be excluded for over the counter items. You can check your account online at any time to review the status of your Card Use Verification and whether your documentation has been approved or denied. If you prefer to submit a paper claim by fax or mail, you can go to www.

If you have lost or misplaced the receipt, you can submit a substitute receipt of equivalent value or repay your account.

The type or description of the service or product. If your Card is suspended, it will be reactivated within 24 — 48 hours after receipts or repayment have been processed for all unverified Card transactions. Remember to also monitor the Statement of Activity page for pending transactions, as it can take up to three weeks to verify a 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 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.

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And remember it takes us two business days for your form to be processed and reviewed. You still will be able to use the Card to purchase certain medical items, such as band-aids, at qualified merchants.

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. A link titled ‘Submit Receipts for Health Care Card Use’ is visible on the welcome page when you first log into your account. 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:.

Pay for services or purchases on the same day you receive them. 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: You are, carx, required to keep each receipt for tax purposes, and in the event it is needed for verification. Attach supporting documentation to your claim by using the upload utility.

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.

Examples of how to use your FSA: 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.

Substitute documentation may be for the same amount as the original transaction or it could add up to the amount of the original transaction. Failure to do so wxgeworks result in your Card being suspended. us

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Only the custodial parent of divorced or legally-separated parents can be reimbursed using the Dependent Care FSA. Substitute documentation must also have verifjcation same five pieces of information we just reviewed.

To pay a provider: Log on to your account at www. 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.

Second, the provider name. Service Description — Detailed description for services crd.

WageWorks Web Tutorial: WageWorks Card Use Verification Form

If you pay for eligible recurring expenses, follow the online instructions to set up automatic payments. When there is a valid change in status, an FSA cannot be reduced to the point where contributions for the plan year are less than the amount already reimbursed for that year. Not only are your Medical Expense FSA funds available to you in one lump sum at the beginning wageworsk your plan year, but your FSA funds are deducted before federal and state taxes are calculated on your paycheck.

Dependent Name — Person who wagsworks the service. Please don’t use a highlighter on anything you send to us as it usually makes the information unreadable when faxed. The fax number, email address and mailing address are listed waegworks the top of the form.