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How to substantiatedebit card transactionsfor Medical FSA and Limited Purpose FSAMarch 31, 2022 2021 Optum Financial. All rights reserved. Do not distribute or reproduce without express permission from Optum Financial.We are now Optum Financial, which includes Optum Bank.
Optum Bank Payment MasterCardCan spend up to youravailable balanceIf you have multipleOptum Bank/Financialaccounts, you will usesame cardFast and convenient 2021 Optum Financial. All rights reserved. Do not distribute or reproduce without express permission from Optum Financial.We are now Optum Financial, which includes Optum Bank.2
My card was accepted for payment. Why do I need to senddocuments to verify?IRS requires all FSA claims need to be verifiedto maintain pretax status of FSA planDoes not match a co-paymenton your health, vision or dentalplanIneligible items included in totalpurchasePlan sponsor is responsible forauditing all transactionsMerchant does not use IIASpoint of sale technologyMerchant has not certified 90% of sales are FSA eligibleOptum Financial administers onbehalf of ParTNers for Health plan.IIAS approved pharmacy list:https://www.sig-is.org/publications 2021 Optum Financial. All rights reserved. Do not distribute or reproduce without express permission from Optum Financial.We are now Optum Financial, which includes Optum Bank.3
What type of documentation is needed for debit cardsubstantiation or filing a claim for reimbursement?Documentation that DOES provideproof of eligible expenseDocumentation that does NOTprovide proof of eligible expenseInsurance plan Explanation of Benefits(EOB) or itemized/detailed Provider receiptthat includes: Credit card receipt only reflecting apayment Bills for services that have not yet beenperformed Receipt for amount due or paid beforeinsurance discounts have been applied(final responsibility) Provider receipt or statement of servicesthat only show a balance due or balanceforward Provider receipt for a co-pay that does notclearly state the item is a co-pay charge1. Date of Service or date expense wasincurred2. Itemized list of purchases or detaileddescription of service or expense3. Name of Patient who incurred the serviceor expense4. Name and address of merchant or healthcare professional5. Dollar amount (after insurance hasbeen applied – your final responsibility) 2021 Optum Financial. All rights reserved. Do not distribute or reproduce without express permission from Optum Financial.We are now Optum Financial, which includes Optum Bank.
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How will I know if I need to submit documentation?1st NoticeDocumentation isneeded2nd NoticeReceipt RequiredReminder3rd NoticeOverdueDebit CardSuspension Arrives by email or letter; advises receipts/EOB needed to further audit expenseWithin 7 business days after card swipeEmails will not give specifics of claim due to privacy regulationsYou can view the specifics by logging in and access ‘Forms and Documents” Arrives by email or letter Sent about 30 days from 1st notice Repeats debit card substantiation request Arrives by email or letter Sent about 15 days from 2nd notice Advises of debit card suspension after 15 more days Arrives by email or letter Advises card has been suspended temporarily To reinstate card – submit proper documentation or repay claim via online ACH or check 2021 Optum Financial. All rights reserved. Do not distribute or reproduce without express permission from Optum Financial.We are now Optum Financial, which includes Optum Bank.6
Where to access debit card claim letters online 2021 Optum Financial. All rights reserved. Do not distribute or reproduce without express permission from Optum Financial.We are now Optum Financial, which includes Optum Bank.7
Online substantiation is preferredhowever, you can Fax, eMail or Mail documents to substantiate your debitcard purchase:Create cover letter that includes yourFirst Name; Last NameEmployer NameLast 4 of SSNClaim # if you have it,Mail:Optum, P.O Box 30516Salt Lake City, UT 16 2021 Optum Financial. All rights reserved. Do not distribute or reproduce without express permission from Optum Financial.We are now Optum Financial, which includes Optum Bank.
Getting Startedoptumbank.com/tennessee 2021 Optum Financial. All rights reserved. Do not distribute or reproduce without express permission from Optum Financial.We are now Optum Financial, which includes Optum Bank.
OptumBank sign in pageYou can log in onyour computer orfrom your mobiledevice using theOptumBank appIf this is your firsttime logging in.You will need tocreate your HealthSafe ID 2021 Optum Financial. All rights reserved. Do not distribute or reproduce without express permission from Optum Financial.We are now Optum Financial, which includes Optum Bank.
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Still need attention after five business day?You will be notified via email or letter in the mailReview the documentations you sent. Does it meetthe criteria discussed earlier?If not, provide additional documentation.Have questions? Giveus a call at the numberon the back of your card 2021 Optum Financial. All rights reserved. Do not distribute or reproduce without express permission from Optum Financial.We are now Optum Financial, which includes Optum Bank.
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What if you have more questions?CallOptum Bank Customer sitwww.optumbank.com/tennessee 2021 Optum Financial. All rights reserved. Do not distribute or reproduce without express permission from Optum Financial.We are now Optum Financial, which includes Optum Bank.
Thank you forattendingInvestments are not FDIC insured, are not guaranteed by Optum Bank , and may lose value.Health Savings Accounts (HSAs) are individual accounts offered or administered by Optum Bank , Member FDIC, and aresubject to eligibility and restrictions on distributions for qualified medical expenses set forth in section 213(d) of the InternalRevenue Code. State taxes may apply. Fees may reduce earnings on account. This communication is not intended as legalor tax advice. Please contact a competent legal or tax professional for personal advice on eligibility, tax treatment, andrestrictions. Federal and state laws and regulations are subject to change.Mutual fund investment options are made available through the services of an independent investment advisor. Shares areoffered through Charles Schwab & Co., Inc., a registered broker-dealer. Orders are accepted to effect transactions insecurities only as an accommodation to HSA owner. Optum Bank is not a broker-dealer or registered investment advisor,and does not provide investment advice or research concerning securities, make recommendations concerning securities,or otherwise solicit securities transactions.Hypothetical examples are for illustrative purposes only. All events, persons and results described herein are entirelyfictitious and amounts will vary depending on your unique circumstances. Any resemblance to real events or persons, livingor dead, is purely coincidental. Current rates are variable and may change at any time. Individual circumstances may vary. 2021 Optum Bank, Inc. All Rights Reserved. WF318661530
Provider receipt or statement of services that only show a balance due or balance . Do not distribute or reproduce without express permission from Optum Financial. We are now Optum Financial, which includes Optum Bank. Still need attention after five business day? You will be notified via email or letter in the mail
