FSA Feds claim being denied over and over again....

[Anonymous]

I had a procedure on August and although my insurance covered most of it, I had to pay $2500 out of pocket. The doctor's office had said FSAwould cover, so 8 submitted the receipt... Well, they denied and said they needed an intemitezed receipt, we submitted that... Then they requested a letter of medical necessity -we provided that... Then they requested it to be coded, the code for the medical necessity... We provideded that, then they said AGAIN it needed to be itemized. My husband sent ALL the doc. Again to them and I just saw it was denied again (separate letter in the mail).

Anyway, we followed their instructions to a T and I know it is covered. After 6 months of this, I'm soooo annoyed! Do we have any resources here besides keep trying in this endless circle? I know with health insurance you can appeal decisions... What about FSA?

Also, the money that is not used.... Does anyone know where it goes? God, I hate stupidcrats!

[Anonymous]

Not sure what you should do, but I recently had them deny my child care claim. I had sent the same documentation that I've been sending for the last five years. I got the additional documentation they required, and they finally paid it. I think they must be making a conscious effort to slow down claims payments.

[Anonymous]

Talk to your HR department. They're the ones that made the contract with this company, so they're the ones who have the most leverage.

[Anonymous]

What?! That's insane! The FSA is your money! The claim is just a claim for your money from your account.

I just signed up for the Dependent Care FSA this year. I'm waiting for it to accrue a bit before I put in a claim; however, now I'm worried.

[Anonymous]

Anonymous wrote:What?! That's insane! The FSA is your money! The claim is just a claim for your money from your account.

I just signed up for the Dependent Care FSA this year. I'm waiting for it to accrue a bit before I put in a claim; however, now I'm worried.

Don't worry about it at all. I, and many colleauges, have been using FSA for years without problems. Especially for dependent care (assuming your nanny signs the form or your day care gives their tax number), there's really no reason they can deny it

[Anonymous]

I'm thinking that these FSA plans have been under fire from the IRS lately. They have definitely tightened up the rules on what you can claim in terms of OTC meds. Too many people were abusing the accounts (using the attached debit cards to buy groceries, etc.).

Anyway, I don't work for the feds, but my husband works for a local county and his FSA administrating company is a pain in the ass. Just got a visit to minute clinic denied this week. Reason: No date of service. Sigh. Take out the receipt, circle the date of service that is clearly printed on the recept with a big black sharpie, and re-submit. Morons.

[Anonymous]

Anonymous wrote:

Anonymous wrote:What?! That's insane! The FSA is your money! The claim is just a claim for your money from your account.

I just signed up for the Dependent Care FSA this year. I'm waiting for it to accrue a bit before I put in a claim; however, now I'm worried.

Don't worry about it at all. I, and many colleauges, have been using FSA for years without problems. Especially for dependent care (assuming your nanny signs the form or your day care gives their tax number), there's really no reason they can deny it

Thank you for your comment PP. You did ease my mind quite a bit.

[Anonymous]

We stopped using FSA a couple a years ago after so much hassle about claims denied and having to resubmit.

As I understand it, the company that administers FSA gets to keep any unclaimed money, so there is an incentive for them to slow down and deny claims. If that's true, what a B*S* way to structure a benefit program.

[Anonymous]

I don't think the administrating company gets to keep the money; I think it goes back to the employer.

PP, have you called FSAFeds and talked to a supervisor? I've never gotten so much runaround from them for anything. That's ridiculous.

[Anonymous]

Have you tried submitting the EOB from the insurance company? That's the best kind of documentation and should satisfy the requirements.

[Anonymous]

I'd call the customer service # for FSA Feds and talk to someone about your issue.

[Anonymous]

Wow, that is amazing. Ours is so easy, we do nothing. It is SOMEHOW linked to our insurance, so we automatically get back all co-pays. My child recently underwent a toncillectomy and I had to pay $500 out of pocket, within 3 weeks that $500 showed up in the mail. We do absolutly no claiming, it gets done for us automagically.

The childcare one, we do ourselves, but we claimed it 2 weeks ago and the 5K just hit our checking yesterday.

[Anonymous]

Thank you for posting this OP. we've had several issues with our FSA money not being reimbursed either! For NO good reason! Been driving us nuts! Glad to know we're not alone.

[Anonymous]

Anonymous wrote:I don't think the administrating company gets to keep the money; I think it goes back to the employer.

PP, have you called FSAFeds and talked to a supervisor? I've never gotten so much runaround from them for anything. That's ridiculous.

Even if they don't get to keep unspent money, they do get the time vaue of the money between the time it's deducted from your check and when the reimbursement is made. A few days or weeks on thousands of accounts adds up.

[Anonymous]

Anonymous wrote:I'd call the customer service # for FSA Feds and talk to someone about your issue.

bingo ...

we've had very few probs. w FSA and have maxed out our contribution and reimbursement every year without a problem.
talk to someone there and get a clearer picture of what's up.