Mobile Design Evolution

9:41

Provider Name *

Service Date *

Amount *

Service Type *

Diagnosis Code

Provider Tax ID *

Receipt Upload *

Tap to upload

Additional Notes

9:41

Healthcare Provider

Visit Date

Amount Paid

Type of Visit

Upload Receipt

📷

Take Photo or Upload JPG, PNG up to 5MB

9:41

1

Capture

2

Review

3

Submit

Step 1: Capture Receipt

Position your receipt within the frame

Align receipt here

💡 Ensure all text is clearly visible

Step 2: Smart Detection

We've automatically detected your receipt details

Provider

Dr. Smith Family Practice ✓

Amount

$125.00 ✓

Date

March 15, 2024 ✓

Step 3: Final Review

Confirm details and submit

Provider: Dr. Smith Family Practice

Amount: $125.00

Category: Office Visit

Expected Processing: 1-2 business days

Design Versions

HSA Reimbursement

HSA Reimbursement

HSA Reimbursement

Step 1: Capture Receipt

Step 2: Smart Detection

Step 3: Final Review

Problems in Existing Design:

Design Versions

HSA Reimbursement

Upload Failed

HSA Reimbursement

HSA Reimbursement

Step 1: Capture Receipt

Step 2: Smart Detection

Step 3: Final Review

Reimbursement Submitted!

Problems in Existing Design: