ConnectYourCare

Account FAQs:
Claims

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In This Section

How do I enter a new claim?
How do I submit receipts for Healthcare Payment Card charges?
How will I know if I need to submit a receipt for substantiation?
What if I don’t submit my receipts?
What information needs to be included on receipts for reimbursement?
Why is a description of service required on my receipts?
Why would my claim be denied?
How long does it take for my reimbursements to be processed?
Can I mail in my claim?
If I fax a claim, do you need originals in the mail?
What is the deadline for submitting claims?
Why would the reimbursement I received be less than the claim I sent?
How can I find out my account balance?

How do I enter a new claim? (Back to top)
Entering a new claim is easy. Simply:

Log into your online account and select Claim Center from the main menu across the top of the screen.
Click on Add New Claim from the left-hand menu.
Follow the four easy steps on the screen to enter information about your claim.
Print your cover sheet and then fax or email it (as a tif or pdf file) with your receipts to the number/email address shown on the form.

How do I submit receipts for healthcare payment card charges? (Back to top)
Even when you use your healthcare payment card, FSA and HRA rules require receipts as verification on many purchases. Always remember to save your receipts. When you are ready to, follow these simple steps:

Log into your online account and select Claim Center from the main menu across the top of the screen.
On the all claims display, the ones needing receipts will show at the top.
Click on Reprint Form* next to the claim to print your cover sheet then fax or email it (as a tif or pdf file) with your receipts to the number/email address shown on the form.

*If you receive a reminder letter in the mail regarding receipts on a claim, you can use that letter as your fax cover sheet.

How will I know if I need to submit a receipt for substantiation? (Back to top)
If a receipt is needed, you will be notified by email or letter within a week of your payment card swipe. You can also review if your claim requires receipts online by logging into your account and visiting the Account Claim Center. You need to submit receipts if you see a notice.

What if I don’t submit my receipts? (Back to top)
You must provide the receipts within the time requested or the transaction will be deemed ineligible, and you will be required to refund the amount of the transaction. If you fail to submit required receipts within 45 days, your payment card will be temporarily suspended. If you fail to reimburse the account, the amount of the ineligible expense(s) may be added to your W-2. Under current regulations, we do not need receipts for HSA account transactions. However, the IRS may require you to present receipts to verify your tax return, so hold on to these receipts as well.

What information needs to be included on receipts for reimbursement? (Back to top)
Receipts MUST include the following information:

Name of the patient (you, your spouse or dependent)
Date the service was provided
Name of the service provider
Description of the service
Amount/cost of the item or service provided

*Credit card receipts, non-itemized cash register receipts and cancelled checks are not acceptable forms of documentation.

Why is a description of service required on my receipts? (Back to top)
The IRS determines eligible expenses and the documentation required to claim a reimbursement from this plan. A documented description of services or products is required to prove that your incurred expense is eligible for reimbursement under the guidelines set by the IRS for this plan.

Why would my claim be denied? (Back to top)
Claims are denied for missing or illegible information, receipts that are for expenses that are not eligible, expenses incurred outside the plan year, expenses that have already been submitted, or expenses that are not qualified for the plan that you are participating in. In the instance of a denied claim, participants have the opportunity to submit the correct information and resubmit the claim for reimbursement.

Be sure all expenses were incurred during the Plan Year before submitting.
Be sure the expenses were not previously submitted.
Make sure that all of the information provided on the receipt you are submitting. Remember that credit card receipts, non-itemized cash register receipts and cancelled checks are not acceptable forms of documentation.
If your claim cannot be processed, you will be notified in writing, explaining the reason and requesting the necessary information needed to process your claim.

How long will it take for my reimbursements to be processed? (Back to top)
Most reimbursements requests filed online are processed within 2-4 business days. Reimbursements are timed differently for various clients. Some reimbursements are made daily, some weekly, and some once or twice monthly depending on the schedule agreed to with your employer. You can see the date of your next reimbursement by selecting "View Reimbursement Schedule" from the online Claim Center. Check with Customer Service or your benefits administrator if you have any questions about the timing for your company.

Can I mail in my claim? (Back to top)
Yes, however, we prefer to receive claims by fax. The option to mail is available but we have found that claims take longer and there is always the chance of your claim getting lost in the postal system.

If I fax a claim, do you need originals in the mail? (Back to top)
If a claim is sent by fax or email, it is not necessary to send the same claim by mail. This creates duplicate claims to process and could lengthen the processing time for all participants.

What is the deadline for submitting claims? (Back to top)
An employee can send in as many claims as they like, as often as they like, throughout the plan year, not to exceed the annual election amount or plan limits. At the end of the plan year, there is a "run-out period" or period of time for which a claim for an expense can be submitted for a plan year that has ended or after an employee has terminated. Your employer determines the run-out periods for the end of the plan year and for those triggered by a termination. Please refer to the written plan enrollment communication materials provided to you or contact Customer Service for more information.

Why would the reimbursement I received be less than the claim I sent? (Back to top)
There are a few reasons why this might happen:

Flexible Spending Account Reimbursements are limited to the annual election (the amount you elected to set aside at the beginning of the plan year). Reimbursements are paid up to the annual election amount at any time during the plan year and will not exceed this amount.

Health Reimbursement Arrangement, Health Savings Account, Dependent Care and Premium Reimbursement Arrangements are limited to the amount on deposit at the time of the claim. For example, if you have made 3 contributions of $50 each, you have would have an account balance of $150. If you sent in a claim for $200, you will receive only the $150 until further contributions are made. As soon as you contribute to the plan, the balance of the claim is paid up to the amount on deposit not to exceed the annual election amount or plan limits.

A portion of your claim may have been denied. If so, you will receive an explanation in the mail explaining why that portion of your claim was denied. If you don’t understand why your claim was denied, you may contact Customer Service for assistance.

How can I find out my account balance? (Back to top)
Account Balance and Claims Status information is available three ways:

Log on to your online account at any time for balance information. Your online account is secure and updated in real time.
Call the Customer Service line at any time for automated balance information.
Customer Service representatives are available to assist you via phone or email during extended business hours.