Serre financial 2026

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4.8 out of 5

61 votes

The document is a MedAfford Pre-funded Claim Submission Form intended for use by employees to submit medical claims to Serre Financial. It outlines the process for filling out the form, including the requirement to fax it along with medical receipts, and specifies that receipts should only be submitted when their total exceeds $100. The document also emphasizes the responsibility of the individual completing the form to ensure accuracy.

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Click ‘Get Form’ to open the MedAfford Pre-funded Claim Submission Form in the editor.
Begin by entering the date at the top of the form. This is essential for tracking your submission.
Fill in your company name and employee name in the designated fields to identify who is submitting the claim.
In the 'Claimant' section, provide details about each claim, including a description, claim amount, and date (formatted as mm/dd/yyyy).
Ensure you attach copies of your medical receipts before faxing the completed form to Serre Financial at 1-866-927-0222.
Finally, sign the form in the designated area to validate your submission.

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2012	4.8 Satisfied (61 Votes)

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