FSA claims 101: A step-by-step through claim reimbursment What do flexible spending account (FSA) participants desire? They might tell you that they want an efficient way to save money on FSA-eligible expenses. Providing that experience requires processing that leads to fast reimbursement of participants’ FSA claims. So what does the FSA claims process look like after a participant purchases FSA-eligible expenses? Please note: Depending on the administrator, you will likely find a different experience when participants pay out of pocket versus using their benefits card.
When expenses are paid for with a benefits card
When expenses are paid out of pocket
This process starts with the participant simply swiping their benefits card at the point of sale. For Benecon participants, that means the claim has already been submitted and the merchant or provider has been paid. And, for 85 percent of claims with our Benecon benefits card, the purchase is automatically approved without additional documentation needed.
If the participant doesn’t have access to a benefits card or chooses not to use one, they will likely need to: 1. File a claim and submit documentation to be reimbursed from their FSA. 2. The claim and documentation are reviewed to ensure the claim meets IRS requirements.
If the participant’s claim is not automatically 3. Hopefully, the participant’s claim is approved approved, Benecon will notify the participant and they are reimbursed! If not, they’ll be to request additional documentation. Once asked to submit additional documentation documentation that meets the IRS’ requirements before they are reimbursed. is received and approved, the claim is approved. For medical FSA claims, documentation should include: • • • •
Date service was received or purchase was made Description of service or item purchased Dollar amount Provider or store name
An Explanation of Benefits (EOB) typically contains the information required by the IRS.