FSA Debit Card Documentation Requirements

What information has to be on the documentation?

When follow-up documentation is required, ASIFlex will send the participant an email or letter requesting this documentation. The requested information should include the following information:

• The name (address, etc.) of the provider;
• The name of the particpant (or particpant's spouse or dependent);
• The date the service(s) was provided (not when it was paid, when the service(s) was actually provided);
• A brief description of the service(s) (co-pay, office visit, dental exam, prescription, etc.); and
• The amount that was the responsibility of the participant (or participant's spouse or dependent)

You will be required to follow-up with substantiating documentation for all other purchases with your FSA Debit Card, including co-payments for your spouse's insurance plan. When you make a purchase *It is important to note that submitting credit card receipts is not acceptable, as that type of receipt does not provide all of the necessary information.

ASIFlex will send the initial request for follow-up documentation within a few days of the FSA Debit Card transaction. If the participant does not comply with the initial request, ASIFlex will make a second request in approximately three weeks. If the participant does not comply with the second request, a third notice will be sent three weeks later stating that the FSA Debit Card has been suspended because the requested documentation was not received by ASIFlex.

Please do not send follow-up documentation to ASIFlex until you receive the email or letter request.