Sending Insurance Documents From The Field


DeBruyne Insurance Agency provides coverage for over 150 business accounts and 200 personalized accounts in the mid-west. Focusing on property and casualty insurance, DeBruyne is an independent insurer providing personalized service and “we’re licensed and ready to do everything,” said Ed DeBruyne, the company’s founder and president.

DeBruyne is an independent insurance agency; rather than working for a bigger insurance company, they focus on serving their clients. They pride themselves on their “old fashioned” approach to business, focusing on customer service and expertise in the industry. The company has two offices and employs four people across locations in Illinois and Wisconsin.

DeBryne Insurance Agency is located at the corner of 5th and Main Street in St. Charles, IL

The Problem

DeBruyne travels all over the Illinois and Wisconsin working in the field with his clients. “The problem came into the mix for me where I work off site and I need a way to fill in the Acord forms [the insurance applications],” said DeBruyne.

“The problem came into the mix for me where I work off site and I need a way to fill in the Acord forms [the insurance applications]”

Ed DeBruyne, Founder and President

DeBruyne’s work takes him to remote corners of rural states far from computers and the office. Sometimes, clients will need insurance documents immediately, even on the weekends when nobody is in the office. “I was off site and I needed documents filled out,” said DeBruyne. “When I’m off site, I don’t have access to the AMS [Agency Management System],” meaning he can’t complete the required forms.

“Waiting until somebody got in the office… was not ideal. I had to do something different. I would get a call on Saturday afternoon when I’m away from both [offices]. One of my contractors says ‘I need a certificate of insurance for work on Sunday morning…’ but here it is at three o’clock in the afternoon, there’s no way anybody is getting into the office to type that certificate out. So that was why I started with PDFfiller to begin with,” said DeBruyne.

DeBruyne Insurance Agency needed a solution that could work anywhere, at anytime, and completely remotely. DeBruyne found PDFfiller.

The Solution

There were two factors that contributed to DeBruyne’s decision to integrate PDFfiller into his company’s workflow: “the only thing I considered was ease of use and speed of use,” he said. Making sure documents could get from the worksite to the main office and vice versa immediately and easily was his priority. Now DeBruyne has been using it for a couple of years “pretty much daily.”

With PDFfiller, DeBruyne and DeBruyne Insurance Agency can fill out forms completely remotely — anywhere from the busy streets of Chicago to the lush fields and bucolic countryside of rural Wisconsin.

The process is easy: “[With PDFfiller], I can find any Acord form in the world — I put it into the system and type it out.” Using PDFfiller’s proprietary drag and drop wizard, DeBruyne can make his paper documents digital and fillable. Once saved as a fillable template in his PDFfiller account, the forms are easy to access and complete from anywhere, at any time, and on any internet-connected device. From there, DeBruyne is just a click away from completion — after he fills out a form, it can be transmitted directly “either to the client, the certificate holder, or both,” right from DeBruyne’s digital device.

“[Time saving] is impossible to measure because before I found PDFfiller, I would handwrite things out and then I’d have to go back to Illinois and type it into the actual forms. This way, boom, I’m one and done, I touch it once and it’s over with. I can email my staff in Illinois, ‘Hey print this out and put it into their file or type it into the AMS system.’ It’s really impossible to measure the amount of time it saves,” said DeBruyne.

While PDFfiller enables him to complete documents electronically, it also enables DeBruyne to edit them online, creating customized solutions for his clients wherever he might be. Whether he needs to add or erase a specific field, highlight or redact important information, or even place a sticky note as a memo to one of the office’s other employees, PDFfiller provides a complete digital document editing platform to ensure DeBruyne Insurance Agency’s can create professional-looking documents for any situation.

Because he is transmitting important and sensitive documents and storing them, DeBruyne was forced to consider their security. It was, “absolutely”, a critical factor in his decision making process, DeBruyne said. A combination of remote storage, redundant backups, high-grade physical security, combined with PDFfiller’s proprietary online security features like two-factor authentication and PIN-protected folders, mean that DeBruyne can be sure that his documents are always completely secure.


DeBruyne “absolutely” recommends PDFfiller as a digital document management solution because, in the field, he and the DeBruyne Insurance Agency can count on it to edit, send, and add signatures to documents. PDFfiller saves DeBruyne time and energy, allowing them to generate more business through a digital document management platform that is faster and easier than a paper-based solution. PDFfiller makes it easy to do business wherever you are and is available whenever you need it.

For the complete paper, click on the link below:

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Obtain Payment for a Deceased Veteran with Form VA 29-4125

Form VA 29-4125: Claim for One Sum Payment

For the purpose of providing financial security to US veterans and their families with respect to significant risks intrinsic to military service, The Department of Veteran Affairs has developed considerable life insurance benefits that last during the whole veteran’s lifetime. In fact, even after the veteran’s death, his family is eligible to receive what is called the One Sum Payment. To receive this benefit, the claimant should be ready to prepare certain papers, the most important being Form VA 29-4125.
In this blog post we will try to help you file the form properly and explain the whole procedure.

Who needs a VA 29-4125 Form?

The Department of Veteran Affairs 29-4125 form is the alternative name for the Claim for One Sum Payment. This form can be submitted by a person who needs to file a claim for the life insurance obtained by a deceased retired member of the military. The claimant is regarded as a veteran’s beneficiary.

What is the VA 29-4125 Form for?

The VA Form 29-4125 is used to claim the payments provided by the government insurance policy.

Is the VA Form 29-4125 accompanied by other forms?

It is mandatory that the VA Form 29-4125 be accompanied by the deceased veteran’s death certificate (a photocopy is allowed) identifying the date and the cause of death.
In case the claimant is not the veteran’s principal or contingent beneficiary, there are also some additional provisions, stating that:

  • If the applicant is a minor or an incompetent person, the letters of guardianship or conservatorship must be included
  • If the claimant is the veteran’s personal representative, they must accompany the Claim for One Sum Payment with copies of testamentary letters, letters of administration or a court order of distribution.

When is the VA 29-4125 Form due?

The Claim must be filed when the need arises.

How do I fill out VA Form 29-4125?

The fillable VA 29-4125 requires providing the following information:

  • Insured veteran data (name, insurance file number, policy number, net amount of insurance, date of death);
  • Beneficiary data (name, relation to the veteran, date of birth, SSN, address, phone number);
  • Beneficiary Signature;
  • Date.

Where do I send the VA Form 29-4125?

The completed, signed and dated Claim must be sent to the Department of Veteran Affairs, Regional Office, and Insurance Center.

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How to Reimburse the Medical Expenses with CMS 1500 Form

CMS 1500: Health Insurance Claim Form

The health insurance system of the USA consists of programs that help individuals pay for medical services provided during their stay in the hospital. This program can be private or funded by the government. The two most well known government insurance programs are Medicare and Medicaid. Actually, these are the basic insurance programs for the USA residents without any health insurance. With time, however, these programs became the standard for health insurance providers. The main point of any insurance program is to return the money spent on medical services. The patient in the hospital shows his health insurance policy to the physician, allowing medical coverage to be provided. After this, the health care provider should take the matter into his own hands. The first step for doing this is to gather all the required information about the medical charges is dealt with. The Centers for Medicare and Medicaid Services have a special document for this purpose – the CMS 1500 form 2015. Read below to learn more.

Who needs a CMS 1500 form 2015?

The Health Insurance Claim form is used by the health care providers to claim for the reimbursement for the services provided to the patients from the government health insurance programs. This form is issued by the Centers for Medicare and Medicaid Services.

What is the purpose of the CMS 1500 form 2015?

This claim form is required to receive payments from the Medicare and Medicaid carriers for the provided services. The physicians and sometimes private insurers complete the claim, indicating the information about the patience and his condition, medical services, and the insurance details.

What other documents must accompany the CMS 1500 form 2015?

Usually, this claim form doesn’t need to be supported by other documents.

When is the CMS 1500 form 2015 due?

The health care provider must file the claim form during the year after the medical services were provided.

What sections should be filled out in the CMS 1500 form 2015?

The physician or other authorized people must add the following details:

  • Type of the insurance (Medicare, Medicaid, Tricare, or other);
  • Information about the patient and the insured (name, address, birth date, sex, insured’s ID number, account number);
  • Information about the insurance (policy group, plan name or program name, health benefits name);
  • Information about the illness (date of the illness, injury or pregnancy, dates of the patient unable to work, hospitalization date, diagnosis or nature of illness or injury);
  • Information about the health care provider (name or referring provider or other sources);
  • Information about the medical services (dates, place, description of procedures, services, or supplies, charges);
  • Federal Tax ID number.

The Health Insurance Claim form must be signed by the patient or insured person and by the physician as well (including degrees or credentials).

Where the CMS 1500 form 2015 should be sent?

The completed claim form is forwarded to the Centers of Medicare carriers.

Real Estate & Insurance Goes Digital


the picture of some woman

Cunningham and Associates is located in San Angelo, Texas, but serves a large rural market with clients all over Texas and some even scattered outside state lines. Despite having to work with customers across a large region, Cunningham and Associates is a small business, consisting of four team members, including Debbie Cunningham herself.
Cunningham and Associates Real Estate and Insurance provides selling, purchasing, and insurance services and advice. They help individual customers find the ideal property or insurance solution.
Debbie Cunningham found PDFfiller through an online search — “I did a trial and I was like wow, this is really pretty easy,” Cunningham said. PDFfiller “just opened up a whole world of usability to access all those documents that we use over and over and over and once I tried it, I was pretty much like, I love it, I wouldn’t go anywhere else.”

Four people in front sitting on chairs probably the human resources department

The Problem

Send and Sign Documents

Cunningham and Associates was facing a number of problems with document transmission before they started using PDFfiller.

With customers scattered across the region, document management and distribution was a serious problem. Texas is a large state and in many cases, real estate deals happen quickly or insurance documents need to be signed promptly. Distance, however, was making this process more difficult – due to the logistics associated with mobile workforces, getting a simple signature could be problematic.

“One [company] I’m working with right now is a trucking company and they have employees that could be anywhere at any time,” Cunningham said, “so getting a paper document to those folks is difficult sometimes.” People would have to come into the office or documents would have to be sent by post.

Double quotes

“When customers hand-write out forms, sometimes it’s legible, but 90% of the time, it’s not, If that document isn’t legible, there’s room for mistakes, errors in judgement, reading the wrong thing.”

– Debbie Cunningham, Real Estate & Insurance Broker

Before using PDFfiller, documents would come back slowly and were often illegible. “When [customers] hand-write out forms, sometimes it’s legible, but 90% of the time, it’s not,” Cunningham claimed. “If that document isn’t legible, there’s room for mistakes, errors in judgement, reading the wrong thing.” These problems with legibility is endemic with handwritten forms.

Transferring sensitive insurance and medical documents also carries risk; this liability is exacerbated by the fact that sensitive medical documents were normally passed through the hands of administrators before reaching employees before Cunningham and Associates started using PDFfiller. “When [or if a form] goes back to the employer, they’re privy to information that it is generally best they do not see,” said Cunningham. “If an employer sees that an employee has any major medical condition condition that they might not have been aware of otherwise… it has the potential for creating a situation where an employee claims discrimination if, for any reason, that affected employee is disciplined for any unrelated cause.”

Double quotes

“We were having to do everything manually by pen and paper and send it to whomever. We didn’t have anything that would do online form-filling.”

– Debbie Cunningham, Real Estate & Insurance Broker

Handling hundreds of documents daily with only a few members of staff was a difficult process. Before PDFfiller, Cunningham and her employees “were having to do everything manually by pen and paper and send it to whomever. We didn’t have anything that would do online form-filling.” They were hoping to save their staff time and energy and free them each from the burden of filling out paperwork for ten hours a week.

Cunningham and Associates needed an electronic solution that was easy for the company’s employees and customers to use; Debbie Cunningham found it in PDFfiller.

The Solution

Send and Sign Documents

Debbie Cunningham and her colleagues use PDFfiller everyday to improve their workflow. “Everybody uses it multiple times a day,” Cunningham said. And for good reason: PDFfiller solves all of the problems Cunningham and Associates had with document distribution. Documents are sent directly to clients and returned legibly in a quick and secure manner. Moreover, Cunningham and Associates forms are transferred to partners, including banks, insurance agents, and the government, efficiently and completely electronically with PDFfiller’s online service. When dealing with documents like insurance claims or purchase agreements, it is critical to be able to distribute, sign, and process documents quickly and, crucially, because much of this information is sensitive, this has to be done in a safe and secure manner. PDFfiller ensures that this is possible, even across large distances.

Fig A. Creating a filliable contract form with PDFfiller

Fig A. Creating a filliable contract form with PDFfiller

Many of Cunningham and Associates’ engagements with clients are “paper intensive and our clients tend to be everywhere, so discovering the fill and sign aspects was a ‘wow moment.’ ” PDFfiller enables users to annotate, edit, fill-in PDF forms and even make PDF forms easily fillable for others. PDFfiller also allows users to send and sign PDF documents completely electronically using its safe, secure, and instantaneous ‘DigiSign’ technology. PDFfiller “saves people from coming into the office,” said Cunningham. Electronic document completion and signing means that “we can collaborate over the phone if [clients] have a question but then they can form fill [important documents] from their computer and it’s been amazing.”

Fig B. Filling and sending contract form by the user with PDFfiller.

Fig B. Filling and sending contract form by the user with PDFfiller.

Documents, such as contracts and insurance claim forms, are fillable by anyone, anytime, and on any device and moreover, they come back legible. Before, Cunningham and her employees would have to manually transcribe illegible handwriting or call to clarify information before they could pass documents on to insurers. “When the underwriters get it, it has to be legible, they want to be able to read it, they want to be able to not spend hours trying to decipher somebody’s hand-scratching, so that’s been great [that with PDFfiller’s electronic document completion, documents are legible].”

Importantly, PDFfiller is easy to use. It’s simple user interface means that anybody can use it. Because it’s completely online, forms can be edited, filled and signed from any internet-connected device at any time. “If it’s not easy to use, they won’t use it,” said Cunningham. “Some programs are not so user friendly [but] the reception [towards using PDFfiller to complete documents] has been really good. We get [documents] back quickly.”

Fig C. Send documents safely and securely with PDFfiller.

Fig C. Send documents safely and securely with PDFfiller.

Cunningham and Associates is responsible for transferring sensitive medical documents and as such, they need to make sure they are HIPAA compliant. Moreover, they need to protect their clients. “You don’t want your employer to see health conditions, so the ability to send directly to an employee [using PDFfiller’s electronic document signing, editing, and transmission] and get that document back without having to rely on an admin person to send and receive those documents [means] we’ve mitigated our risk for HIPAA compliance [and] if we can isolate that information and bypass the employer it protects the employee,” Cunningham said.

The Benefits of
Using PDFfiller

Return on Investment

PDFfiller is the fastest way to edit, send, and sign documents. According to Cunningham, “[Workflow] was a lot slower” before integrating PDFfiller into her business and using PDFfiller saves her firm “probably ten hours per person per week, so that’s 30 hours per week.” For Cunningham, because the man hours PDFfiller saves are significant, cost savings for the company are “considerable.”


PDFfiller makes it easier for her clients to complete, sign and return forms. Because forms are completed completely electronically, PDFfiller also makes it easier for Cunningham and Associates to read and collect the information as well as transfer documents to businesses, individuals, government agencies, legal and medical providers, and insurance agents. Moreover, PDFfiller is simple to use and the powerful features that make document workflow so efficient are easy to apply: “It was so easy to set up and start using — we haven’t had any issues,” Cunningham said.


PDFfiller is HIPAA compliant, which means that all your documents are stored and transmitted completely securely. Moreover, because PDFfiller allows Cunningham and Associates to transfer documents directly to clients, rather than work through third parties, they mitigate risk — “you also run the risk of that document getting waylaid to the wrong fax number or wrong email, so if it’s a protected document then you don’t need to worry about that possibility,” said Cunningham.

Completely Digital

Going digital doesn’t just mean it’s easier to sign and send documents. It also means that all the documents that are such an important part of Cunningham and Associates’ business workflow are stored digitally. Because everything is digital, documents are secure and searchable. Never worry about important documents being lost or accidentally destroyed and PDFfiller’s secure servers mean they’re secure as well.


PDFfiller offers a variety of solutions to the many document transmission problems that had plagued Cunningham and Associates. With a small team, Cunningham knew she needed to make her workflow as efficient as possible and “any kind of tool in your quiver to make that process more advantageous and save time, especially if you don’t have a team of support people behind you, [it’s a good thing],” she said. PDFfiller allowed Cunningham and Associates to send and have document signed as quickly as possible, meaning the company could spend more time focusing on their business and on relationships with their customers and less time on paperwork.

As she and her employees continue to use the software, they keep finding new ways to integrate it into their workflow and improve their business and relationships with clients. Cunningham is particularly excited about using PDFfiller on various mobile devices: “Everyday we learn different ways to use it and I’ve realized now I can use it on my phone [and iPad] too; I haven’t branched out that far yet, but that’s exciting because I do work in the field a lot,” and with PDFfiller, she can capture a client signature while at an open house or get a buyer’s representation agreement on the spot. “The sooner you can get that [signature] the better, so if you’re having that conversation with somebody and you can whip out an iPad, because you’re not always going to have a desktop… it would be awesome if I had that document loaded [and ready to give to customers and get signatures with PDFfiller].”

Double quotes

“Everything we do and everything we touch on the health side has to be HIPAA compliant and privacy is important nowadays. So with PDFfiller, we have mitigated risk — that’s a hard thing to quantify.”

– Debbie Cunningham, Real Estate & Insurance Broker

Ultimately, PDFfiller has “made our lives a whole lot simpler, for sure,” Cunningham said. The benefits of using PDFfiller are manifold: “Everything we do and everything we touch on the health side has to be HIPAA compliant and privacy is [important] nowadays. So [with PDFfiller], we have mitigated risk — that’s a hard thing to quantify,” said Cunnigham. Though PDFfiller saves the company money, the benefits go far beyond costs. “[the savings] aren’t just dollars, it’s efficiency [and] privacy,” she said.

For the complete paper, click on the link below:
pdf   Real Estate & Insurance Goes Digital

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Get Prepared to Report Your Work Activity to the SSA on Form 821-BK

Form SSA-821-BK – Work Activity Report-Employee

When you want to claim Social Security disability benefits, you should be prepared for a thorough inspection by the Social Security Administration (SSA) as they are obligated to make sure that a person claiming and receiving the disability benefits is lawfully eligible for them. One of the possible types of information requests from the SSA may be a requirement to submit the SSA-821-BK form, or Work Activity Report-Employee. In fact, the SSA directs form 821-BK to an individual who is already receiving disability insurance benefits (which means they are considered disabled and cannot be working) to make sure that the beneficiary hasn’t been doing any work activity since the alleged onset date. On the other hand, if the insured beneficiary has indeed been doing any kind of work and has any earnings, it is strongly recommended that he file the Work Activity Report SSA-821-BK Form at once. In this blog post, we will tell you more about this SSA form.

Who needs an SSA-821-BK Form?

It is used by the SSA to process information about any work performed by SSDI beneficiaries, who may have gained any earnings for work activities after claiming disability.

What is Form SSA-821-BK, Work Activity Report for?

This Report aims to provide detailed information for work activity that was performed after SSA disability benefits have been issued. On the basis of the data provided in the report, the SSA will make a decision on whether the beneficiary is still eligible for disability benefits.

Is the Work Activity Report Form accompanied by other forms?

Typically, there is no need to attach any other forms or documents to the SSA-821-BK form, unless it is clearly communicated by SSA. However, there is a provision requiring confirmation of any payments claimed on the form; therefore, the applicant should attach any relevant pay stubs.

When is SSA Form 821-BK due?

The fully completed report form should be returned to the SSA local office within 15 days from its receipt, if sent by the SSA.
If it is the beneficiary’s initiative to file a form, it should done be as soon as possible after any payments were received.

How do I fill out Form SSA-821-BK?

The Work Activity Report- Employee Form is an eight-page document that must explain the work activity or type of income in all full detail as demanded by the SSA. Therefore, when completed it should provide the following details:

  • Personal information about the insured disabled person;
  • Name of wage earner in their family;
  • Type of benefits received;
  • Information about the work activity and earnings;
  • Employment data;
  • Special work conditions (if any);
  • Any special payments and work expenses;
  • Vocational rehabilitation (if any).

Finally, the report form must be signed and dated by the disabled individual and a witness.

Where do I send Work Activity Report Form?

After Form SSA-821-BK is thoroughly filled out, it should be directed back to the office that sent it to you.