Get Form 07 - Extended Health Care Bclaim Formb - Writers39 Coalition - Writerscoalition

Completing the Form 07 - Extended Health Care Claim Form is an essential process for users seeking reimbursement for extended health care expenses. This guide provides detailed, step-by-step instructions to help users successfully fill out the form online, ensuring all necessary information is accurately provided.

Follow the steps to successfully complete the form online.

1. Click the ‘Get Form’ button to access the claim form and open it in your document editor.
2. In Section 1, provide your member information. Fill in your name (last, first, middle initial), date of birth (in the format DD MM YYYY), account number, and if applicable, your ACTRA/WGC number. Indicate which program you participate in by checking the appropriate box.
3. In Section 2, enter claim details. For each insured individual, input their insured code (00 for member, 01 for spouse/partner, 02 for dependant), name, date of birth, type of expense, date of service, and the amount on the receipt. Repeat this for each expense being claimed. Ensure you attach original receipts.
4. In Section 3, state whether you or your dependants are covered under any other insurance plans. If yes, provide the required information about the other insurance, including the name of the insured, the other insurance company, and policy details.
5. In Section 4, sign and date the authorization. Ensure that you and the member (if applicable) provide your signatures and the corresponding dates.
6. After completing all sections, review your entries to ensure accuracy. Save any changes made to the document.
7. Finally, submit your completed and signed form to AFBS via mail. You may also choose to deliver your form to the AFBS western office if more convenient.

Complete your documents online today to ensure timely processing of your claims.