Get Hca Wageworks

Completing the Hca Wageworks form is essential for obtaining reimbursement for eligible medical expenses. This guide provides clear, step-by-step instructions to help you fill out the form accurately and efficiently.

Follow the steps to complete your Hca Wageworks claim form.

1. Click ‘Get Form’ button to access the Hca Wageworks form and open it for editing.
2. Enter the account holder information in the designated fields. Fill in your last name, first name, social security number, zip code, employer or program sponsor's name, and birth date in MM/DD format. If you have a new email address, include it in the provided field.
3. Review the certification and authorization section. You must confirm that the medical services were provided while covered under the company's Flexible Benefit Plan and that the expenses have not been reimbursed elsewhere.
4. Sign and date the form in the appropriate areas, verifying your responsibility for the accuracy of the submitted information.
5. Complete the unreimbursed medical expense claims section. List the date of the expense incurred, the name of the service provider, a description of the expense, and the total health care expense claim.
6. Attach the necessary receipts as documentation of expenses. Ensure each receipt clearly displays the service date and type. Note that canceled checks or credit card slips are not acceptable.
7. Save your changes and finalize the document. You can choose to download, print, or share the form as needed.

Complete your claims form online to streamline your reimbursement process.