We have purchased a new accounting package for our flex program. As with all change, this can be a traumatic event (but then who wants to go back to shoveling rock instead of using an end loader). With your help, we are hoping to make the change as smooth and trouble-free as possible.

     The first thing with a new program, it seems, is that we find fault with them because nothing works the same as it did before. Once we begin to work with the program, we discover that at least some of the changes are for the better.

     Along with the changes for the administrator, there are also changes for you, in your filing of claims. This is where we really need your help, in order to make things work as efficiently and correctly as possible.

     First of all, there will be NO cut-off date. Claims will be posted DAILY. Once a month, between the 12^th and the 15^th, we just tell the program to print checks for everything that has been posted up to that time.

     You should file a claim every time you have any type of service that is eligible for payment from your flex account. When you receive an Explanation of Benefits (EOB) from the insurance company, turn around and send in your claim. For something that is not covered by insurance, when you receive the service, or make a purchase, file a flex claim right away. This has two advantages: It helps us out, but most importantly, you aren’t going to have to dig through 3, 6 or 12 month’s of papers to get your flex claim filed by a certain deadline.

     We have changed the new claim forms and, hopefully, have made them simpler, so they are not so intimidating. (THROW AWAY ALL OF YOUR OLD FORMS.) You will also notice that there is only room to list a few claims, going back to the idea that you need to do this weekly, or as soon as you have any claim to file.

     Please be sure you send the proper receipts with your claims. As we have stated many times, the Explanation of Benefits from the insurance company is the BEST receipt you can use. If you are on the company insurance, this is the ONLY receipt you can use for prescriptions. Since prescriptions are automatically filed with the insurance company, the EOB is the only way to know what has been allowed and paid by insurance, if anything.

     For anything that is not covered by insurance, you need to use an itemized invoice. This invoice must show the date of the service, the patient’s name, the provider’s name, a brief description of the service, and the amount charged. Cash receipts, cash register slips, credit card receipts or cancelled checks are NOT eligible receipts. It is also not necessary to show proof-of-payment, so please do not send your cash slips, cancelled checks, or credit card receipts along with the invoices or EOBs.

      With the new program, when you do not have proper receipts, a letter will be generated and the claim will go into a “Pending file” and will not be paid until the requested information has been sent in. When this information has been received, the claim will be released for payment on the next check run.

     Some additional information:  We have learned that there are new auditing companies being formed for the purpose of auditing flex programs across the country. Already, there are companies who have been fined thousands of dollars for “irregularities” in their flex programs. If claims have been paid that are not valid or do not have proper documentation, it’s possible the company would not only be fined, but the individual would be required to make up the taxes, fines, and penalties on a personal level. It’s just best for all concerned to try to keep within the rules.

     We think we have a good program and have tried to keep within the IRS guidelines to the best of our abilities. Hopefully, that would pay off in the event of an audit.

Here are a few statistics regarding the flex program that you may find of interest.

Amount of Withholding for Un-reimbursed Medical, Dependent Care

Amount & Number of Claims