Tips For Submitting Claims

//Tips For Submitting Claims

The following tips will ensure the fastest processing of your claims, and quickest turn-around times for getting your reimbursement.

That way if we have a question about your claim, or if something did not transmit properly, we can contact you right away to resolve the issue. This avoids any delay of your reimbursement due to incomplete information.
When you itemize your expenses for us, it really helps us to be sure that we are getting in everything that you are expecting. If we miss an expense because it was not listed on the claim form, it may delay your reimbursement.
For each receipt you have, use one line on the claim form. There is no need to list each item on a single receipt on separate lines on the claim form. We don’t want you to do unnecessary work, we just want to be sure we are getting all the data entered the way you want it. So if you have a receipt with 50 items on it, and 8 that you are claiming, against your medical FSA here’s how you do it;

  1. In the box that says “Date expense incurred” – this is the date you physically incurred the expense – you got services or purchased an item. The day you went in and got services may be different from the date you paid for those services, this is especially common in medical billing. The IRS is looking only at the date of services and not the date of payment, and this is important, because sometimes this can mean the difference between a claim being approved or denied.
  2. Name of service Provider – in this case it would be the name of the store you bought all 50 items at. If it was a doctor or other provider, their name or business name goes in this box.
  3. Expense description – this box is especially important if the receipt description of your expense is extremely hard to determine. Some stores are not overly descriptive of the items on their receipts, and if you can give us an indication of what this item is, it will speed the processing of your claim greatly.
  4. Person for whom expense incurred – this box tells us who in your “tax-family” actually incurred the expense. In the case of items purchased, it would be whom the items were for.
  5. Medical Expense Claims – this box is where you put the dollar amount of your claim.
  6. MySource Card Swipe indicates to us if this claim you are submitting is in reference to a MySource FSA Debit card swipe that required your sending in additional substantiation in regards to an expense. You can either write yes, no, or put an X to indicate Yes in this box.
Filling out multiple claim forms is unnecessary work for you. If you have too many receipts to fit on one of our claim forms, you can simply fill out one claim form, and then attach an itemized listing of your expenses on a separate page. This can be handwritten, typed or even laid out on a spreadsheet.
  1. The pharmacy where you get your prescriptions can probably print you out a listing of every Rx you’ve purchased there. You simply give them a date range, say every Rx you bought in 2008, and they’ll hand you a free printout that is the perfect “receipt” to send in to our offices for reimbursement of your Rx purchases. These printouts have the date range on top for us, so we can see right away that all dates fall within your current plan year (or prior year for “Grace period” claims). Then we can look all the way to the bottom and there is the total. Also it means that there is no need to save or submit those little Rx “slips” that come with your medications. One easy printout can have you on the fast-track to reimbursement.
  2. Additionally we know that many retailers use an identification system to identify FSA eligible over-the-counter or OTC items. So if you use you use their card to buy FSA eligible items, a similar printout is available to you detailing all your eligible OTC purchases for your given date range.
An Explanation of Benefits is a detailed reporting of expenses you’ve incurred that were submitted to your medical insurance carrier. The EOB is a standard document that insurance companies use to list providers, dates of service, person for whom the services were provided, and the patient’s financial responsibility –this is exactly the data that the IRS requires to substantiate medical expense claims. When you have a medical expense that goes through your insurance, a short time after the services are rendered, an EOB is generated. In most cases this is mailed to you, but you can also go to your insurance company’s website and download the EOB related to your expense (most or all major carriers). An EOB is the best receipt we can have and will ensure the quickest processing of your reimbursement.
It helps us when the expenses that are itemized on your claim form are in the same order as the receipts you submit. So that the receipt for the first line of your claim form is the first receipt, and the second line on your claim form represents the second receipt following the claim form. Of course this is not necessary, but it may help you organize your claim better, and it certainly helps us process it quicker which may mean you have your money in your hands sooner.
Did you know we publish a schedule for each employer that shows what days we process reimbursements? For each employer we usually reimburse claims once or twice a month, so by knowing the days we process you can ensure the quickest turnaround time on your claims. If you have your claim into our offices before 4PM (for claims under 20 pages. Claims over 20 pages 3PM cutoff) we will process the reimbursement first thing the next morning. The reimbursement should be in your hands or direct deposited into your account within a few business days. You were given a reimbursement schedule at your Open Enrollment. To get an electronic copy of your reimbursement schedule, you’ll need to log into the secure part of our website (Open a login box?) Once you’re logged into your home page in the secure site, one of the navigation buttons to the left of the screen says Documents, click that button. Then click “Section 125 documents” and you should see a file to download called Calendar (or some variation of that). Click on that and choose Save. Save it to your desktop or somewhere handy for future reference.
  1. Once you’ve submitted your claim, you can log into your online account and view a history of all your submitted claims and reimbursements. Our information uploads to the web at about 4AM each day, so if you submit a claim today before 4PM, you will be able to log in tomorrow and view that your claim was entered properly. If you notice that any parts were denied or if the number does not match your records, please feel free to give us a call and we’ll be happy to take a look at your claim and make sure that we entered everything correctly. If the claim is entered properly, our claims professionals will be able to explain why the claim is entered in way you were not expecting.
  2. Do you need help logging in for the first time? Give us a call at 954-883-9970 and we’ll be happy to walk you through the first time login process. Instructions were given to you at Open Enrollment, but generic instructions are available here. However you must get your “Employer Code” from your HR offices, or by calling our office to obtain that information.