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What happens when a claim is denied?

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

  • The Claim Form was not signed.
  • The requested amount was not included on the Claim Form.
  • Improper provider receipt to document expenses (Charge receipts, debit slips and cancelled checks cannot be accepted to document your claim. They indicate a payment date and not necessarily the date the service was rendered, nor do they indicate type of service rendered.).
  • Expense is ineligible (example:  cosmetic surgery). View a sample list of eligible expenses here.
  • Expense was not incurred during the current plan year.
  • The provider receipt does not indicate the actual date the service was incurred.

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.