Each week, BAS receives more than 2,500 flexible spending account and/or health reimbursement account claims. Approximately 85% of claims submitted to BAS are properly filed and substantiated, and, subsequently, reimbursed during the weekly claims reimbursement on Tuesday. However, some claims cannot be paid because the substantiation supporting the claim does not contain sufficient information. Common examples of receipts that do not contain enough detail to substantiate a claim include: cash register receipts for prescription copays; provider payment receipts that do not contain dates of service or the reason for the expense; and receipts for services or items with both a medical and non-medical purpose (also known as dual-purpose items or services) that are not accompanied by a physician’s letter of medical necessity.
Many FSA/HRA plans offer a period for participants to cure denied claims. For plans subject to ERISA, the period is typically 180 days or more from the date the claim is denied. Correcting an claim that was denied because of inadequate substantiation can be easy. We offer suggestions below to assist with correcting a denied claim.
1. Identify the claim that was denied and the reason for the denial. Log on to www.MyEnroll.com and click on the FSA Balances and History Tab. Locate the claim and review the corresponding denial code. Click on the code for a brief description of the reason the claim was denied.
2. Obtain an Explanation of Benefits or a new itemized receipt to substantiate the denied claim. Use last week’s article as a checklist to evaluate the claim and supporting receipt(s) to determine what information is needed.
3. Include a copy of the email from MyEnrollServices@BASusa.com with your resubmission. This will assist with expediting the resolution of the claim.
4. Fax your resubmission to: 888-265-2144 or mail it to BAS P.O. Box 62407 King of Prussia, PA 19406.
If you have questions about Flexible Spending Accounts (FSA) or Health Reimbursement Accounts (HRA), please contact us, as follows:
- HR Administrators and Brokers: contact your Account Manager, or email Service@BASusa.com, or call 800-945-5513, option 4.
