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FSA FAQsClaim Reimbursement
 How will I receive reimbursement for eligible services? After a service is provided, you will need to submit a completed and signed claim form with the supporting documentation to Benefit Resource who will review your claim and issue you a reimbursement for eligible expenses. If you elect Direct Deposit reimbursement, funds will be deposited directly into your bank account and a Direct Deposit advice will be sent to you to notify you that this has been done. Otherwise, a check will be mailed to you. How long will it take to receive reimbursement for my claim? Claim reimbursements are processed every Wednesday and will include claims received by Benefit Resource at least 5 business days prior to the processing day. If you elect Direct Deposit reimbursement, funds should be available in your account on Friday (unless your bank delays availability of electronically transferred funds). Reimbursement checks and Direct Deposit advices will be mailed to you on the Friday following Wednesday's processing. Is there a minimum claim submission amount? There is no minimum claim submission amount, but your Plan may have a minimum reimbursement amount (usually $15). If a claim is submitted for less than the minimum, it will be held until the total of all eligible claims submitted exceeds the minimum. During the run-out period after the end of each Plan Year, reimbursements will be issued even if they are less than the minimum amount. Must all my claims be submitted before the Plan Year ends? No. Claims for eligible eligible services must be received by Benefit Resource within the timeframe indicated in your Plan Highlights. Can I submit a claim for a medical service prior to paying for it? As long as the service has been provided, a claim can be submitted for reimbursement regardless of whether or not payment has been made. Can I submit a claim for a medical service before the service is provided if I have already paid for it? You should submit your claim after that service has been provided since reimbursement is based on date the service was provided and not based on date of payment. (Note the IRS exception for orthodontia below.) How does reimbursement for orthodontia expenses work? IRS regulations allow reimbursement of eligible orthodontia expenses based on date of payment, date of service or payment due date on statements/coupons. (Note that reimbursement of other eligible dental procedures is based on dates of service.) Will the money I elect for my FSA be paid directly to the provider? No, payment will be made to you. You are still responsible for paying the provider. Where should I submit my claim first for medical expenses: to my insurance or my Medical FSA? Your claim must always be submitted to your insurance carrier first. Then the remaining eligible expenses that you pay out-of-pocket can be submitted for reimbursement from your Medical FSA. What supporting documentation do I need to submit with my completed claim form for reimbursement from my Medical FSA? Acceptable supporting documentation for medical claims must include the following information:
For services covered in whole or in part by insurance, the expense must first be submitted to your insurance carrier. The insurance carrier will issue an Explanation of Benefits (EOB) to you, indicating your out-of-pocket cost and the amount covered by your insurance. When you submit your claim, include this EOB with your completed claim form. If all of the required information listed above is not clearly indicated on the EOB, you will also need to submit a receipt/statement from the provider of the service/product.
Additional supporting documentation from a licensed medical practitioner may be required for certain medical claims. For example, a service or product that could have a cosmetic, personal or non-medical element would need to be substantiated on the Certification of Medical Necessity form by a licensed medical practitioner indicating a specific medical diagnosis and that the service is required to treat that medical condition. Can I submit a Dependent Care claim before a service is provided if I have already paid for it? Since reimbursement of eligible Dependent Care services are bsed on date of service and not date of payment, you should submit your claim after the service has been provided. For example, if you pay a summer day camp registration in March but the day camp will be held in July, the claim for reimbursement of the March registration fee cannot be submitted until the end of July. What supporting documentation do I need to submit with my completed claim form for a Dependent Care claim? Acceptable supporting documentation for a Dependent Care FSA claim must include the following information:
Note that cancelled checks and credit card statements are not acceptable as supporting documentation. What happens if the cash balance in my Dependent Care FSA is less than the amount of an eligible claim that I submit? Your claim will be reimbursed up to the cash balance available in your Dependent Care FSA. You will be reimbursed for the rest of the claim once additional funds are deposited into your Dependent Care FSA. If I pay my daycare center the same amount every single week, can I automatically receive reimbursement from my Dependent Care Account without submitting a claim every week? Since eligible Dependent Care services cannot be reimbursed until after the service has been provided, reimbursements cannot be automatically generated for you. You can submit claims weekly or you may accumulate claims and submit several weeks at one time as long as the services have already been provided. |
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