Comments on: PayFlex: an FSA administrator actually does something right

By: jik

jik — Mon, 16 Apr 2012 18:52:37 +0000

they reject regular Dr. Bills causing me to have to take time out of an incredible busy schedule to resend and resubmit bills…

Since you’ve said nothing about why your bills were rejected, we have no way to evaluate the validity of your complaint. Judging from the cluelessness displayed in the rest of your comment, I think it’s more likely that you are doing things wrong than that PayFlex is.

I’ve been using a PayFlex FSA for three years now, and I think in all that time, they’ve only incorrectly rejected two claims, and one of those was in sufficiently confusing circumstances that I don’t blame them for it.

One claim that PayFlex rejected was not only correct, it even led me to discover that a doctor had double-billed me for a copayment, so the PayFlex rejection actually saved me money.

As several other commenters have noted, PayFlex does not set the rules for what documentation is required to substantiate claims; the IRS does. Blaming PayFlex for enforcing rules that it did not make and cannot change is at best unfair, and at worst just plain stupid.

even after they STOLE my 800.00 balance. Never once did I receive a statement ever about my balance. EVER WHY DON’T THEY SEND STATEMENTS …BECAUSE THEY ARE A RIP OFF.PAY FLEX IS A RIP OFF.

PayFlex didn’t steal anything from you.

You chose through your employer how much money to put into your FSA account. It is your responsibility to keep track of it.

You were told when you signed up for your FSA, or should have been, that any unused balance is forfeited at the end of the plan year.

Your balance is easily available for you to view on the PayFlex web site any time you want to go look at it.

Every time you file a claim with PayFlex, you receive an EOB which tells you how much of your balance is left.

If your employer is anything like mine, you received multiple warnings after the close of the plan year that you needed to use up your remaining balance or it would be forfeited. I’m not sure, but I think PayFlex even sends you such reminders if you give them your email address. (I’m not sure, because I delete these reminders too quickly for them to stick in my brain, because I have enough of a clue to know long before they tell me that I need to use up my FSA funds or I’m going to lose them.)

If your forfeited money in your FSA account at the end of the year, you have only yourself to blame, and you’ve got no right to blame PayFlex for your own stupidity.

By: bee

bee — Mon, 16 Apr 2012 09:40:56 +0000

Not happy with my pay flex plan either.they reject regular Dr. Bills causing me to have to take time out of an incredible busy schedule to resend and resubmit bills…even after they STOLE my 800.00 balance. Never once did I receive a statement ever about my balance. EVER WHY DON’T THEY SEND STATEMENTS …BECAUSE THEY ARE A RIP OFF.PAY FLEX IS A RIP OFF.

By: Unhappy with Payflex

Unhappy with Payflex — Tue, 31 Jan 2012 01:00:17 +0000

Repeatedly, Payflex has made mistakes forwarding correct information regarding my health care policy to United Healthcare while I am on leave. Their regular incompetence has led them to direct my health care carrier to terminate my health policy on two occasions in the past 2 1/2 years. Getting the policy reinstated is always very time consuming on my part and Payflex refuses to accept any responsibility or make corrections to keep the same thing from happening in the future but directs all the blame on the health care insurance company. I have found Payflex to be overall incompetent in their duties that should be considered very seriously and done with scrutiny.

By: Barbara Snow

Barbara Snow — Fri, 25 Feb 2011 21:53:26 +0000

I too have had nothing but trouble with PayFlex. It turns out my doctors don’t write their bills the way PayFlex wants them, the hospital doesn’t provide the right kind of receipts and since I can’t whip Blue Cross Blue Shield into line, their documentation is not useful either. I hate it.

By: Ronald Bertswarth

Ronald Bertswarth — Fri, 21 Jan 2011 07:57:08 +0000

Finito, yes that Joshua poster must work for PayFlex because he actually has facts and references on hand and actually makes sense unlike most of the complainers here.

PayFlex does not set the rules on what’s reimbursable and what isn’t; that’s the IRS, and you should know that by now, so to take your frustration out on PayFlex is absurd. With that said, dental implants are FSA eligible and if your claim was denied for implants then I would exercise your option to appeal the denied claim. If you paid for cosmetic veneers, then the IRS does not consider that eligible and thus your claim would be denied.

You should check out IRS publication 502 and 969 as I did after reading Joshua’s post; they’re quite informative.

By: Finito

Finito — Mon, 06 Dec 2010 04:08:48 +0000

My interactions with Payflex this year have consistently been some of the most frustrating and infuriating of any customer service experience. Ever. For any reason. Apparently I am going to lose the almost $2000 balance. If you are considering signing up for Payflex, you might want to ask yourself: if your front teeth were knocked out in an accident, and you had set aside money out of every paycheck into an FSA for just such an emergency, would you expect that having your front teeth knocked would be a reimbursable expense. If you answered Yes, DO NOT sign up for Payflex. Apparently they think front teeth are optional. Worst company ever.

That Joshua poster must work for Payflex.

By: jik

jik — Tue, 25 May 2010 13:31:02 +0000

I was having a lot of trouble with PayFlex rejecting my PDFs when I was using FireFox on my MacBook. I switched to IE on a Dell and now it works fine. I think PayFlex might either have a browser issue or a Mac/Windows issue. Hope that helps.

I just successfully uploaded a PDF to Payflex using Firefox 3.6 on a Mac.

By: Joshua

Joshua — Fri, 14 May 2010 23:12:58 +0000

Just FYI people, per IRS publication 969 and 125, ALL reimbursements MUST be substantiated BEFORE reimbursement is given. When you use your debit card, you are receiving immediate reimbursement and if the transaction cannot be automatically substantiated through the merchant’s IIAS (Inventory Information Approval System, which affects ALL FSA debit cards), then per publication 969 and 125, the administrator is required to request the documentation to substantiate the claim. If it is not substantiated and the IRS audits the administrator, they are fined heavily if they don’t ensure IRS compliance.

Also, some of you have mentioned the card being inactivated due to overpayments from providers. Per IRS regulations, all reimbursements must be made based on final patient liability. This is how much you owe AFTER any discounts, credits, adjustments or insurance payments for example. If you’re paying your dentist for example based on an ESTIMATE of what your insurance will pay, that is not eligible for reimbursement under IRS guidelines, so why is it fair to PayFlex to allow them to be fined by the IRS for your negligence in using the card improperly??

Also I have noticed a lot of complaints about “not being notified” of documentation request letters, however, as a PayFlex cardholder myself, I have opted into their eNotify service which emails my documents to me rather than by paper mail. This is great. It’s faster and more convenient, and if I change my email address and I don’t receive my notification, who’s fault is that? Certainly not PayFlex’s as they’re just sending the letters to the place I told them to. If you’re not getting them by mail, I would suggest you complain to your post office.

By: sab

sab — Wed, 07 Apr 2010 00:07:44 +0000

PayFlex is through my husband’s employer–nothing but trouble this year!!!!!! what a joke!!!!!!
We have done everything they have told us and still have a hold on the card – could not pay for my prescriptions with it today!!!
It seems like our doctor overcharged on a fee and therefore $88.00 did not qualify. When we were at KU (regular visit-go every 6 weeks) last week the card was denied when I paid for the visit-paid with debit card. Then card was again denied at the pharmacy-paid with debit card.
Contacted PayFlex and they stated since the doctor overcharged they had put a hold on our account. We faxed them in the documentation that we just spent over $90.00 out of pocket which would offset this doctor’s filing problem. They said 48 hours we should be able to use my card. Well it has been one week later and I just tried and it was again denied.
Now they tell us they never received the fax of the documentation that we had spent the $90.00 out of pocket—my husband faxed it as he was talking to them.
If we could get out of this company we would but we cannot for one year!!! In the meantime they have $1200.00 of our dollars!!!!!!!! which we cannot seem to access!!!!!!!!!!!
I WOULDNOT recommend this company to anyone–I have also understood from our pharmacy what happened to me tonight has happened to many of their clients on PayFlex.
Last year in 2009, we used the card without any of this–they tell us now it is because of the government changing regulations.
So who do I contact to really complain??? Insurance commissioner–government office???

By: jik

jik — Mon, 29 Mar 2010 11:46:32 +0000

Did you report the problem to them? What did they say?