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Health Care Flexible Spending Account (HCFSA) Program
Each EOB, bill, receipt or claims form must contain the following information: . Name of patient receiving service. . Amount charged for service. . Date(s)
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Healthcare Flexible Spending Account Reimbursement Form
Aug 2, 2022 How to file a claim: Online: The fastest way to receive reimbursement for your completed claim is through the web or MyChoice Mobile.
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2022-hcfsa-claim-frm.pdf - NYC.gov
Each EOB, bill, receipt or claims form must contain the following information: . Name of patient receiving service. . Amount charged for service. . Date(s)
Learn more