What happens when a claim is denied?

Sometimes, an FSA reimbursement request must be denied. Common reasons include:

  • Improper provider receipt to document expenses (Charge receipts, debit/credit card slips and canceled checks cannot be accepted to document your claim. They only indicate a payment date, which is not necessarily the date the service was rendered, nor do they indicate type of service rendered.).
  • Expense is ineligible (examples: teeth whitening, eyewear protection plans, cosmetic surgery).
  • Expense was not incurred during the current plan year.
  • The provider receipt does not indicate the actual date the service was incurred (for example, receipt just shows “prior balance”).

Participants receive either email notification or a letter in the mail which thoroughly explains the problem(s) with their claim and provides instruction, as appropriate, toward the successful submission of their claim.