Get Medcom Forms

Filling out the Medcom Forms online is a straightforward process that allows users to submit claims efficiently. This guide provides step-by-step instructions to ensure accurate completion of the form and a seamless submission experience.

Follow the steps to complete the Medcom Forms online.

1. Click ‘Get Form’ button to obtain the Medcom Forms and open it in your preferred editor.
2. Begin by entering your employee name and social security number in the designated fields. If your name has changed, provide your former name as well.
3. Update your address if it has changed. Fill in your new street address, city, state, and zip code accurately.
4. Attach the necessary substantiation documents. For medical claims, include an insurance explanation of benefits and a medical provider invoice. For dependent day care claims, provide itemized invoices, tax ID numbers, and details regarding the dates of service.
5. Indicate the total amount for medical expenses and dependent day care expenses. Ensure the totals correspond to the attached documentation.
6. If you are filing a dependent care assistance program (DCAP) claim, answer the provided questions regarding payment frequency and confirmation of workdays during the claim period.
7. Itemize your expenses in the dedicated section, including the provider's name, date incurred, and the total submitted.
8. Review the certification statement and ensure you agree to all stipulations outlined. This is necessary to proceed with your claim submission.
9. Finally, sign and date the form to certify its accuracy and completeness. Saving your changes and documentation is essential before submitting your claim.
10. You may save changes, download the completed form, print it for your records, or share it as necessary.

Start filling out your Medcom Forms online today for a streamlined claims experience!