SUBSTANTIATION

What is substantiation?

Because FSAs use pre-tax dollars, the IRS requires that all FSA payments be validated to confirm that funds were used for qualified medical expenses. Substantiation is the proof that a purchase is eligible, which is confirmed through itemized receipts/invoices/explanations of benefits.

When is it needed?

Always. Every transaction using FSA dollars must be validated. Some transactions can be verified automatically, but others may require you to submit documentation or receipts supporting your purchases. Because of this, HealthEquity recommends keeping an itemized receipt for every debit card purchase you make.

Convenient, automatic substantiation

Our debit card process allows for auto-substantiation at the point of service in many different cases:

• CoPay matching – If your employer notifies HealthEquity of your health plan copay amounts, HealthEquity will attempt to match transactions against those copay amounts.
• Recurring claims logic – By sending in documentation for the first transaction, any subsequent transactions at the same location for the same amount will not require documentation.
• Claims file matching – If HealthEquity receives claim files from your health plan and can match that claim to a card transaction, no additional documentation will be required. You are also able to manually match a card transaction to a claim if it did not match automatically.

Where can I use my debit card?

IRS rules state that FSA debit cards cannot be used at locations unless the retailer uses a certain type of medical coding. If your pharmacy or provider does not have these merchant category codes, your debit card may be declined. However, you can still submit a reimbursement request if purchasing a qualified item or service.

Requests for documentation

Card transactions that are not substantiated at the point of service will trigger a communication to the member with clear and concise instructions on how to submit supporting documentation. Please respond to these requests as quickly as possible to ensure continued use of your FSA debit card funds.

Your documentation type can vary. It can be an itemized receipt, invoice, explanation of benefits or other, but must include the patient name, name of the provider/pharmacy, the service/item purchased, date of the service/transaction, and dollar amount.

Once appropriate documentation is received, it is routed to a HealthEquity team member for review and approval.

Where can I view which transactions still need substantiating?

You can view all transactions requiring substantiation by logging in to the online member portal. There you will find a complete list of transactions requiring additional documentation, and you can upload your receipts directly to the member portal for review.

What if I can’t find the required documentation?

In cases when a transaction is deemed ineligible or documentation is not provided, members may submit an alternate receipt that has not yet been reimbursed, or a personal check to reimburse the account.

Documentation Library

HealthEquity makes it easy for you to keep track of your documentation and archive items for later access. You can upload receipts on our easy-to-use online member portal. Your files will remain stored in a safe, secure place. You can also see the status of current substantiation requests online at any time.