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Fringe Benefits Management Company a Division of WageWorks Mail to P. O. Box 1820 Tallahassee Florida 32302-1820 Toll-Free Fax to 1-888-800-5217 Customer Service 1-800-342-8017 Interactive Benefits Information Line 1-800-865-3262 FBMCWW/CLAIMARK5217/1011 FOR MULTIPLE PAGES IMPORTANT INFORMATION FOR REIMBURSEMENT To AVOID DELAYS please read these instructions carefully. IMPORTANT REQUIREMENTS INFORMATION not following these requirements may cause .

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How to fill out the Duke Wageworks online

Filling out the Duke Wageworks online claim form can seem daunting, but this guide will help you complete it with ease. With clear instructions for each section, you will be equipped to properly submit your claims for reimbursement of qualified expenses.

Follow the steps to complete your claim form effectively.

  1. Press the ‘Get Form’ button to access the Duke Wageworks claim form and open it in your editor.
  2. In the personal data section, accurately fill in your name, home phone number, street address, city, state, and zip code. Ensure all details are correct to avoid processing delays.
  3. Provide your SSN or Employee ID number, along with your employer's name and your daytime phone number. If this is a new address, ensure to check the designated box.
  4. Read and acknowledge the certification statements regarding the use of your FSA/HRA. You must sign and date at the bottom of this section.
  5. For the payment type section, check the applicable box(es) for your claims regarding medical expenses, and clearly indicate the amount you are claiming.
  6. Enter the required details in the medical FSA or HRA section for eligible expenses. Include the service date, name of the person receiving service, their relationship to you, the provider of services, and the amount for which you are responsible.
  7. If applicable, complete the dependent care FSA section with similar details. Ensure to input the name and age of the individual receiving care, along with the service date ranges.
  8. Review your form for completeness. Ensure all necessary documentation is attached to support your claim.
  9. Finally, save your changes, and consider downloading, printing, or sharing the completed form for your records before submission.

Complete your Duke Wageworks claim form online today for a smooth reimbursement process.

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© Copyright 1997-2026
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Your Privacy Choices
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
altaFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2026
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232