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Claim Filing Procedures:

Health Care FSA

Per IRS regulations, all each item that you are requesting reimbursement for must be substantiated with documentation from the provider, or an independent third party (such as your insurance company).  Each piece of documentation must include the following information:

  • Date(s) of service
  • Description of the services provided
  • Dollar amount charged
  • Name of the person for whom the services were provided
  • Provider information

Please note that proof of payment is not required in order for your reimbursement request to be processed (orthodontia is the one exception to this rule).  If you submit proof of payment (e.g. a credit card receipt) and no other documentation, yr claim will be denied.

Common problems with Health Care FSA claims:

  • No signature on the claim form.  IRS regulations require a signed statement from the participant be included with every claim submission.
  • Documentation is included that only shows that a payment was made (e.g. a credit card receipt).  Proof of payment is not sufficient documentation as it does not indicate what services were provided on what date.  Instead, it only shows the payment date.  There are many services provided, even by medical doctors, that are not reimbursable through your FSA program, so detailed documentation must be included for each item you are claiming.
  • The documentation provided shows a balance forward.  Again, the documentation must explicitly state the date(s) of service and provide a description of the services rendered.

Dependent Care FSA

Just like the Health Care FSA, Dependent Care FSA participants must substantiate each claim submission.  In order to substantiate each claim submission, the participant must provide documentation that includes the following information:

  • Date(s) of service
  • Description of the services provided
  • Dollar amount charged
  • Name of the person for whom the services were provided
  • Provider information

Or, instead of providing documentation that includes the information above, you can simply have the daycare provider sign the ASIFlex claim form.  If this is done, no documentation is required.

Common Problems with DCFSA claims:

  • No signature on the claim form.
  • Services are being claimed before they have all been provided.  Even if your provider requires that you pay for your child care services in advance, you cannot claim these expenses until they have all been provided.  If you are required to pay for expenses at the beginning of a month for that month's services, you can either submit a claim at the end of each week that month, or wait until the end of the month to claim the entire month's expense.  However, you cannot submit a claim at the beginning of the month for services that have not yet all been provided.