1. What is my account balance or the status of my claim?
Members can access their account information via our web site or over the
phone.
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Web site - from your member information center, click on "myClaimCenter" and "FSA
Claim Inquiry"
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Toll-free phone number: 800-826-9781 ext. 2189. You will prompted to enter your
Social Security number/Member number and a four-digit pin number.
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Claim Service Representatives (CSR): submit a question to our CSRs by email from the
web site, or ask directly over the phone
2. How do I get my Group number?
Group number should be provided in a Welcome letter when the account is originally set up. If
the member does not have this number a CSR can help the member to obtain it.
3. How long does it take for a claim to be processed?
The standard turnaround time for most Health Care Account (HCA) claims is within ten working
days (99 percent). Generally, a small percent of Health claims require further substantiation or
clarification.
Please note : Once the claim is processed it will appear on the UMR web
site.
4. Is my claim eligible for reimbursement?
Please refer to your Summary Plan Document for specific regulations. The link below will take
you to a list of
FSA Eligible and Ineligible Expenses
5. How do I complete the claim forms for my Flexible Spending Account?
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There are two separate claim forms: one for dependent care and one for health care,
be sure you are using the correct one. To access the forms,
click here
.
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Include a copy of third party documentation containing 1) date of service, 2) type
of service, 3) charge amount, 4) patient name and 5) provider name for each claim. This could be a
bill or statement from the provider, or an Explanation of Benefits (EOB) from your benefits
administrator.
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It is important that you submit claims to your benefits administrator before
submitting them to your FSA. You cannot be reimbursed from the FSA any amounts that may be covered
by another source.
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To allow for proper reimbursement, you must include the total reimbursement amount
being requested on the claim form.
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The claim form needs to be signed and dated. UMR cannot process your request without
a signature.
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Make a copy of your documents for your records before submitting them to the Flex
Spending Department.
6. What information should I include when I fax an FSA claim to UMR?
Include a cover sheet with the employer name, employee name, daytime phone number
and number of pages being faxed.
The toll-free fax number to submit your claims to is: 877-390-4782.
7. What is a letter of Medical Necessity and what expenses require this?
Expenses that could be considered dual purpose (having both medical and personal benefits)
may need a medical practitioners note explaining the diagnosis and treatment action that is needed
for this specific medical condition. Some examples of expenses that require a letter of medical
necessity are: massage therapy, capital expenses, weight loss programs, and dietary
supplements.
8. May I be reimbursed for my spouse's medical expenses or is the account meant only for my
expenses?
The Health FSA can be used to cover the medical expenses of the member, their spouse, and
their dependents even if those family members are not covered under the employee’s medical and
dental benefits.
9. Are prescription co-pays reimbursable?
Yes. Prescription Drugs are an eligible expense.
10. Are insurance premiums of any kind allowable for reimbursement under the Health
FSA.
No
11. How are Orthodontia claims reimbursed?
Because Orthodontia services can span more than one plan year, services are reimbursed based
on the dates the services were incurred. UMR can reimburse for the member’s orthodontic payments,
made within the FSA plan year, in accordance with a reasonable payment plan, so the initial payment
and monthly installments are eligible without an actual service being provided. Please refer
to your plan document or contact customer service for your individual plan specifics.
The above information is key to our success in processing your Flexible Spending Account
claims without delay.
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