Get Bd Hcp Ocr Form Page1 - Acclaris 20100204.doc

The BD HCP OCR Form is essential for requesting reimbursement for health care expenses. This guide provides clear and structured instructions to help users complete the form accurately online, ensuring a smooth reimbursement process.

Follow the steps to fill out the BD HCP OCR Form online.

1. Press the ‘Get Form’ button to access the BD HCP OCR Form and open it in the editor.
2. Begin with section 1: Your Information. Fill in required fields using capital letters. Include your Participant ID or Social Security Number (without dashes), Employer or Group Name, Last Name, First Name, Email, and Daytime Phone Number.
3. In section 2: Your Expenses, document each health care expense. Use one line for each expense and record necessary details including the Expense Code, Dates of Service (from and to), Provider Name, Amount, and the name and relationship of the person who received the service.
4. Move to section 3: Self Certification. Review the certification statement, then sign and date the form. Ensure your signature is present, as it is required for reimbursement processing.
5. If you need additional lines to list expenses, refer to page 3. Repeat the process for sections as needed, ensuring to use capital letters throughout.
6. Once the form is completed, users can save changes, download, print, or share the form as required. Ensure all supporting documentation, such as itemized receipts, is attached appropriately.

Complete your reimbursement request today by filling out your form online.