Claim Appeal Form February 18, 2025 16:31 Updated If your claim has been rejected in error, and you would like to appeal the claim decision, please fill out the form below. Related articles How long does it take to get reimbursed? Prohibited Services and Goods What if my paid receipt total is more than the funds available? How to submit a claim for parents and guardians. Can I submit a receipt if I purchased a good or service from a business or organization that is not on the marketplace?