With documents like these, your claim would be approved
All required details should be included:
- Name of provider
- Name of patient (who received the item/service)
- Description of service
- Date of service (not date payment was made)
- Amount charged (not amount paid as this could differ from amount charged for eligible service/item)
Both examples contain all required information for claim approval, including (1) name of provider, (2) name of patient, (3) description of service, (4) date of service, (5) amount charged.
With documents like these, your claim would be denied
Some of the required details are missing. Here are some quick tips:
- Make sure the date is the date of service, not the date payment was made.
- If the claim is for a range of dates (7 weeks, for example), the document must show detail for each week.
- Double-check that the name of the person who received the service (the name of your dependent) is included, not the name of the account holder.
- For third-party receipts, Social Security number (SSN) or tax identification number (TIN) with signature are required to approve the claim.
- Please remember amount paid is not equal to amount charged. The document must show amount charged for the eligible service/item.
This document is missing date of service (payment date is not sufficient as date of service).
This document is missing date of service (payment date is not sufficient as date of service), amount charged (amount paid is not acceptable) and a description of service.
This document needs to be from a third-party provider (with Social Security number or TIN of provider) and show date of service to be an acceptable form of documentation.
Flexible spending accounts (FSAs) and dependent care assistance programs (DCAPs) (collectively, “Employer-Sponsored Plans”) are administered on behalf of your plan sponsor by Optum Financial, Inc. or ConnectYourCare, LLC (collectively, "Optum Financial") and are subject to eligibility and restrictions. Employer-Sponsored Plans are not individually owned and amounts available under the Employer-Sponsored Plan are not FDIC insured.
This communication is not intended as legal or tax advice. Federal and state laws and regulations are subject to change. Please contact a legal or tax professional for advice on eligibility, tax treatment, and restrictions. Please contact your plan administrator with questions about enrollment or plan restrictions.