Medical Reimbursement Form Template

Streamline your claims process and easily create workflows to save critical time.

Simplify your workflows

Give your members the ability to claim their money at any time with this mobile-friendly form template. Just customize the form and embed it on your website so users can submit medical claims online from the convenience of their laptop, phone, or tablet. Create workflows to decrease manual data entry errors.

Reduce risks with HIPAA compliant forms

Use Formstack’s medical reimbursement application to let users submit their medical claims while staying HIPAA compliant. Securely store the information you collect, and even integrate with other HIPAA compliant apps for easy data routing.

Give users peace of mind

Let users know their request has been received with automated confirmation emails that include copies of the submitted medical reimbursement form. You can also route the data to the appropriate team member to start processing the claim.

Keep forms short and relevant

Choose exactly what questions users see with conditional logic that automatically updates the medical reimbursement form template as it’s being filled out. Create the illusion of a shorter form with “smart questions” that populate depending on how previous questions were answered.

Improve your existing forms

Already have a form template available? Import it via URL or HTML to recreate it in the Formstack builder interface in a matter of minutes. Save hours of time by bypassing manual input and even updating your forms right in the platform.

Using Formstack reduces failure when bringing in new patients. It increases efficiency and cuts down on data entry for both patients and staff.
Dr. Chris Bojrab
President of Indiana Health Group

Take control of your data with Formstack

Discover the power of turning data into dynamic action with low-code application building from Formstack.