Get Fsahra Reimbursement Form

How do I fill out a reimbursement expense receipt? Complete your company's expense reimbursement form by including an itemized list of expenses with totals. Next, attach a receipt for each item to the form and submit it to your manager or through your company's online portal.

See if your provider or insurance company can provide copies for you. If you cannot provide the document(s) requested by Benefit Resource, or if an expense is ineligible: You may repay the expense or provide a substitute claim to offset it.

You must have a receipt or an explanation of benefits from your insurance carrier for each health care claim you submit against your account.

While FSA funds are deducted by the employer during payroll, the benefits vendor administering the FSA is responsible for verifying the receipts rather than the employee.

Using an FSA debit card will often mean you don't have to submit receipts to your administrator, but it's always a good idea to hold onto your receipts just in case they're needed for any reason.

Submit Your Claim in One of These Ways Log in to your account. ... Once you have logged into your account, click Submit Receipt or Claim and select your Reimbursement Option. Follow the step-by-step instructions. Upload digital copies of your itemized receipts (and other documentation if needed).

Required Documentation: Itemized statement from the provider with a clear description of service provided, name of the patient, date of service, the amount paid for service, and name of the provider. A signed statement indicating there is no insurance coverage for the service provided.

Required Documentation: Itemized statement from the provider with a clear description of service provided, name of the patient, date of service, the amount paid for service, and name of the provider. A signed statement indicating there is no insurance coverage for the service provided.