An Update on Filing Discovery Benefits/Flexible Spending Claims

| April 2, 2013

This year, Webster University’s insurance committee, comprised of faculty and staff, selected Discovery Benefits as our third-party flexible spending plan administrator, to ensure full compliance with IRS regulations on our behalf. Specifically, IRS regulations require verification for any charges outside of our standard medical plan co-payments.

For medical expenses, this includes:

  • Date of service/purchase
  • Description of service/purchase
  • Billing code/number relating to medical procedure/prescription drug
  • Dollar amount
  • Provider/Store

Since Jan. 1, Discovery Benefits has processed nearly 2,300 transactions for Webster University faculty and staff, with 18 percent requiring this form of verification. As of the end of March, less than 10 percent of the claims are pending justification.

Common Issues

The most common issues arise when a payment does not clearly indicate the service, or there is pending insurance payment. In fact, where insurance is involved, the best documentation to provide is an Explanation of Benefits (EOB) which will reflect the amount that remains after insurance has paid. Additionally, a medical necessity form might be requested for further explanation of a procedure or supply that might be considered personal use or over-the-counter.

You can use your debit card for expenses beyond co-payments, but be pro-active and send the required documentation indicated above to Discovery Benefits. This can be done by mobile application, online through www.discoverybenefits.com, fax or mail.

What To Do When Documentation is Needed

Once a debit card is used for an expense that requires further substantiation, Discovery Benefits will notify employees the next day as well as 30 days following the debit. This will be communicated by email if there is one on file, or by U.S. mail if not. Employees have up to 72 days to submit documentation to verify the expense.

Caution: If no documentation is submitted to verify the expense within that time frame, your debit card will be put on hold until the expense is verified. Ultimately, you are responsible to repay or offset any outstanding expenses that are not verified.

Helpful Tip:  When the provider, service and amount being charged are reoccurring, employees can indicate this on the substantiation form and subsequent services can be automatically substantiated.

If you have any questions regarding how to provide this documentation or substantiating future claims, you can contact Discovery Benefits at 1-866-451-3399 or contact Cheryl Fritz, manager, benefits and compensation, at cherylfritz49@webster.edu or 314-246-7055.

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