[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-303751-105":53,"doc-detail-303751-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","claim-form-dependent-care-account-claim-submission","Claim Form - Dependent Care Account Claim Submission","","Guide for submitting a Dependent Care Account claim for reimbursement of eligible dependent care expenses. Explains the rule that reimbursements apply only to services already incurred, with “incurred” meaning the service was received rather than the bill being paid. Provides three submission methods—mobile app, online portal, and paper—covering documentation requirements, provider certification options, and steps for entering claim details. Includes mailing and fax instructions and a provider certification/documentation form.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/claim-form-dependent-care-account-claim-submission/303751/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/claim-form-dependent-care-account-claim-submission/303751.png","ImageObject",442,249,{"name":88,"@type":89},"Aria","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-23","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":79},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What services are eligible for reimbursement under the Dependent Care Account?","Question",{"text":108,"@type":109},"Eligible items include dependent day care expenses that allow you and/or your spouse to work, look for work, or attend school full-time, such as child and elder day care, before/after-school care, summer day camp, nursery school, and pre-school costs.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"When can you request reimbursement for dependent care expenses?",{"text":113,"@type":109},"Reimbursement applies only to services already incurred. An expense is incurred when the service is received, not when a bill is paid, so you cannot request reimbursement until after the service is provided.",{"name":115,"@type":106,"acceptedAnswer":116},"What documentation is required when submitting a claim?",{"text":117,"@type":109},"Provider certification or documentation is required. If your provider completes the Provider Certification section, you do not need to submit additional documentation; otherwise, attach an itemized statement showing required provider and service details.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},303751,1789806707,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":79,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":125,"read_time":9},2336464648322,"https://ap-avatar.wpscdn.com/avatar/2200025388227c56fec?_k=1778556882303663488","How to Submit a Claim for Dependent Care Accounts  \nWe offer three easy ways for you to access your Dependent Care Account funds. For fastest results, we encourage you to submit your claim with the Optum Financial mobile app.  \nFor Dependent Care Accounts, you may only receive reimbursements for services already incurred. An expense is incurred when a service is received, not when a bill is paid. Even though your service provider may require payment atthe beginning of the service period, you cannot request reimbursement until after the service is provided.  \nMobile App Claim Submission – Fastest Method  \n1. Collect Documentation: Collect an itemized statement from your dependent care provider containing the required information (Provider’s Name, Dependent’s Name, Service Period, Payment Amount and Care Being Provided) . Or, ask your provider to complete the Provider Certification section on the Dependent Care Account Claim and Provider Documentation Form (included in this document) . If your provider completes the Provider Certification, you can submit that as your documentation.  \n2. Submit Claim and Documentation: Download the Optum Financial mobile app from your app store. Sign in using your existing Optum Financial website username and password. Click “Make a payment” from the main screen. Enter the requested information about your claim and continue through the screens to confirm, take a picture of your documentation, upload the picture to the created claim and submit.  \nOnline Claim Submission  \n1. Collect Documentation: Collect an itemized statement from your dependent care provider containing the required information (Provider’s Name, Dependent’s Name, Service Period, Payment Amount and Care Being Provided) . Or, ask your provider to complete the Provider Certification section on the Dependent Care Account Claim and Provider Documentation Form (included in this document) . If your provider completes the Provider Certification, you do not have to submit additional documentation.  \n2. Submit Claim and Documentation: Sign in to your online account [at](at optumfinancial.com. Follow the)[ ](at optumfinancial.com. Follow the)[optumfinancial.com.](at optumfinancial.com. Follow the)[ Follow the](at optumfinancial.com. Follow the)[ ](at optumfinancial.com. Follow the)[instructions to enter a new claim. Enter the requested information about your claim and continue through the](instructions to enter a new claim. Enter the requested information about your claim and continue through the)[ ](instructions to enter a new claim. Enter the requested information about your claim and continue through the)[screens to submit the claim and required documentation via fax or upload.](screens to submit the claim and required documentation via fax or upload.)  \nPaper Claim Submission  \n1. Collect Documentation: Ask your provider to complete the Provider Certification section on the Dependent Care Account Claim and Provider Documentation Form (included in this document) . If your provider completes the Provider Certification, you do not have to submit additional documentation. Or, collect an itemized  \nstatement from your dependent care provider containing the required information (Provider’s Name,  \nDependent’s Name, Service Period, Payment Amount and Care Being Provided) .  \n2. Submit Claim and Documentation: Fax the form with receipts and required documentation to (443) 681-4602.  \nWhen you fax the form and supporting documentation, there is no need to follow up with a hard copy in the mail. Remember to keep the original claim form and supporting documents for your records.  \nIf you choose to mail your form and documentation instead of faxing, the address is:  \nClaims Department  \nP.O. Box 622317  \nOrlando, FL 32862-2317  \nDependent Care Account Claim and Provider Documentation Form  \nUse this form to submit your claims for reimbursement of eligible dependent care expenses.  \n• Eligible items include dependent day care expenses so you and/or ","cbCaiomEIUQvEwJi","https://ap.wps.com/l/cbCaiomEIUQvEwJi","pdf",185564,"English","# How to Submit a Claim for Dependent Care Accounts\n## Dependent Care Reimbursement Rules\n## Mobile App Claim Submission – Fastest Method\n## Online Claim Submission\n## Paper Claim Submission\n## Dependent Care Account Claim and Provider Documentation Form\n## Personal Information (Form Section)\n## Claim Details (Form Section)","[{\"question\":\"What services are eligible for reimbursement under the Dependent Care Account?\",\"answer\":\"Eligible items include dependent day care expenses that allow you and/or your spouse to work, look for work, or attend school full-time, such as child and elder day care, before/after-school care, summer day camp, nursery school, and pre-school costs.\"},{\"question\":\"When can you request reimbursement for dependent care expenses?\",\"answer\":\"Reimbursement applies only to services already incurred. An expense is incurred when the service is received, not when a bill is paid, so you cannot request reimbursement until after the service is provided.\"},{\"question\":\"What documentation is required when submitting a claim?\",\"answer\":\"Provider certification or documentation is required. If your provider completes the Provider Certification section, you do not need to submit additional documentation; otherwise, attach an itemized statement showing required provider and service details.\"}]","Claim Form - Dependent Care Account Claim Submission | PDF"]