English to Spanish Law/Patents Insurance

Proof of expense
There are a number of required items that must be included in every claim, either on the Explanation of Benefits from the Insurance Company, or the itemized bill from the provider:
• Date(s) of service
• Name of provider(s)
• Description of services provided
• Condition requiring treatment (for medical claims)
• Amount of expense and any insurance payments (if applicable)
• Signature of provider on claim form if no receipt is available (for Dependent Daycare claims only)