Claim Adjustment Request

If you believe that the amount of your payment is incorrect, we want to know about it.

Adjustment requests:

  1. Must be received in the WECA Food Program office no later than the 15th of the month in which you received the payment.
  2. Cannot be processed for late claims.
  3. Cannot be processed for provider error, for example, incorrect information on scanned forms such as menu forms and child enrollment forms, missing paperwork, etc.

Always check your scanned form copies first. If incorrect information, such as wrong date of birth on a child enrollment form, was bubbled-in, contact the WECA office immediately. Remember that the scanner “reads” the bubbles on scanned forms.

We can correct the incorrect information so your next claim will process properly. We cannot adjust for it.

Child Enrollment Forms must be on file at the WECA office when your claim is processed. If a child is less than one year old, both a completed Parent/Provider Formula Agreement and a Child Enrollment Form must be on file at the WECA CACFP office when your claim is processed.

Your request will be reviewed after the 15th of the month. Payment for an approved adjustment request will be included in your next claim reimbursement. If your request is denied, you will receive a denial letter at that time. We appreciate your cooperation in this process.

Claim Adjustment Request Form

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