What type of documentation is required for reimbursement?

According to IRS guidelines, all claims submitted through Flexible Spending Accounts (FSAs) must be substantiated by independent third-party providers to verify eligibility of the expenses. The third-party information must describe the following:

  1. Patient’s Name: The name of the person who received the service or for whom the item was purchased. For retail store purchases, this information may be excluded.
  2. Provider’s Name: The provider that delivered the service or the merchant where the item was purchased.
  3. Date of Service: The date when services were provided or the item was purchased.
  4. Type of Service: A detailed description of the service provided or item purchased.
  5. Cost: The amount paid for the service or product and/or the portion that is not reimbursed through your insurance carrier.

Health Care Expenses
If the expense was submitted to your insurance for payment, you will need to submit an Explanation of Benefits (EOB) to establish the amount that was not paid by the insurance plan. If the expense was not submitted to your insurance, you will need to submit itemized bills from the provider. If the expense was a prescription, submit the tag from the RX bag or a pharmacy summary. Please be aware that cancelled checks alone are not sufficient documentation to verify an expense. Keep the original receipts for your records and send copies.
For most medical expenses, proof of a payment is not required. For orthodontia expenses; however, you must include documentation to indicate when payment was made along with the above information.
If over-the-counter (OTC) products were purchased, you will need to submit a copy of the receipt clearly indicating the name of the OTC products purchased.
Dependent Care Expenses
In addition to the above requirements, Dependent Care FSA claims require additional information including:

  • Name and age of dependent
  • Provider information including name, address, and Tax ID number or Social Security number
  • Proof of payment