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If you elect to take advantage of a dependent care FSA, you must complete IRS Form 2441 when you file your income taxes for the year. Form 2441 and instructions are available on the IRS website at www.irs.gov.
Log into your FSA account or use the unique account url provided by your employer. Click "Submit Receipt or Claim." Request "Pay My Provider" for healthcare or Dependent Care and follow the instructions.
Healthcare FSA receipt requirements. Reimbursements from a healthcare FSA can only be paid to reimburse the employee for qualified medical expenses incurred during the period of coverage. These reimbursements often require a detailed receipt or invoice detailing the eligible expenses incurred.
In order to get your transaction approved, you must upload an itemized receipt or an explanation of benefits. It's easy to do! Just make sure your receipt includes the following: The name of the provider or merchant.
If you don't submit your receipt, your card may be deactivated for your FSA. You'll still be able to use your card for any other Flex Benefits accounts. You'll need to submit the receipts through your dashboard for the expense in order to have your FSA reactivated.
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A proper receipt should include: Merchant Name; Date of Purchase; Description of Item; Amount Paid. A credit card receipt from your Card swipe is not sufficient. Prescription \u2013 Documentation for a prescription should include: Name of Patient; Name of Pharmacy; Date (fill date); Prescription Number or Name; Amount Paid.
Make sure receipts include the following five pieces of information: Patient's Name. The name of the person who received the service or for whom the item was purchased. ... Provider's Name. The provider that delivered the service or the merchant where the item was purchased. Date of Service. ... Type of Service. ... Cost.
Depending on the location in which your FSA debit card was used, HRCTS may require a receipt. Generally this is done because the location where you made the purchase provides both eligible and non-eligible services under the IRS Guidelines. The most common receipt requests will be for dental and vision expenses.
Dependent care FSA receipt requirements Dependent care FSA eligible expenses also require documentation. An itemized receipt with the five pieces of information is compliant. They need the date(s) of service, dependent's name, provider's name, type of service, and the total dollar amount paid for the services.
If you don't submit your receipt, your card may be deactivated for your FSA. You'll still be able to use your card for any other Flex Benefits accounts. You'll need to submit the receipts through your dashboard for the expense in order to have your FSA reactivated.

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