FSA claims 101: A step-by-step through claim reimbursement

What do flexible spending account (FSA) participants desire? They might tell you that they want an efficient way to save money on FSA-eligible expenses. Providing that experience requires processing that leads to fast reimbursement of participants’ FSA claims.

So what does the FSA claims process look like after a participant purchases FSA-eligible expenses ? Please note: Depending on the administrator, you will likely find a different experience when participants pay out of pocket versus using their benefits card.

When expenses are paid for with a benefits card

This process starts with the participant simply swiping their benefits card at the point of sale. For WEX participants, that means the claim has already been submitted and the merchant or provider has been paid. And, for 85 percent of claims with our WEX benefits card, the purchase is automatically approved without additional documentation needed.

If the participant’s claim is not automatically approved, WEX will notify the participant to request additional documentation. Once documentation that meets the IRS’ requirements is received and approved, the claim is approved.

An Explanation of Benefits (EOB) typically contains the information required by the IRS.

When expenses are paid out of pocket

If the participant doesn’t have access to a benefits card or chooses not to use one, they will likely need to:

  1. File a claim and submit documentation to be reimbursed from their FSA.
  2. The claim and documentation are reviewed to ensure the claim meets IRS requirements.
  3. Hopefully, the participant’s claim is approved and they are reimbursed! If not, they’ll be asked to submit additional documentation before they are reimbursed.

WEX has also simplified the ability to upload documentation with EOB Smart Scan. Watch our video below to see how easy it is.

fertility benefit for HSA and FSA

Health Savings Accounts (HSA)

Support your employees’ fertility benefit needs with an HSA or FSA

non-discrimination testing

Health Reimbursement Arrangements

Non-discrimination testing: Stay compliant with FSAs, HRAs, and more

IRS Use-or-lose rule FSA

Flexible Spending Accounts (FSA)

The IRS use-or-lose rule and what it means for FSAs

FSA mid-year

Flexible Spending Accounts (FSA)

Do this FSA mid-year check to stay ahead of the game

fsa design tips

Benefits Podcast

10 FSA design tips

FSA substantiation requirements

Why FSA substantiation matters and what to look for

Stay connected

Subscribe to our Inside WEX blog and follow us on social media for the insider view on everything WEX, from payments innovation to what it means to be a WEXer.

" * " indicates required fields

Find out how WEX can help grow your business

Contact us

WEX is a global commerce platform that helps businesses solve for operational complexities like employee benefits, managing and mobilizing fleets, and streamlining business payments.

Fuel cards and fleet

Business payments

Employee benefits

Industries

Developers

Company

Resources

Customers

Policies