Follow the steps to successfully complete your claim form online.

1. Press the ‘Get Form’ button to obtain the Riverside Rehnonline Com and open it in your editor of choice.
2. Begin by filling out your participant account and contact information. Input your account number or Social Security number, date of birth, last name, first name, mailing address, city, state, zip code, area code and phone number, and email address.
3. In the reimbursement request section, indicate whether the claim is for yourself, legal spouse, qualifying child, qualifying relative, or other by selecting the appropriate option.
4. Provide details for the expenses you are claiming. Fill in the date of service, last name, first name of the person for whom the claim is submitted, their gender, date of birth, Social Security number, type of service or item, and the amount paid.
5. If submitting claims for multiple expenses, ensure you add them up to verify the total before moving on.
6. Fill out the second claim section if applicable, repeating the information required for additional expenses just like in step four and five.
7. After completing all necessary sections, provide the required certification by signing and dating the form. Remember that e-signatures are accepted.
8. Review the form to ensure all information is accurately filled out. Save your changes, download a copy for your records, and prepare to submit it via email or fax as provided.

Complete your claims today for quick processing and reimbursement.