Claim documentation requirements are prescribed by the IRS, not by Vita Flex nor your employer. As such, satisfying the IRS requirements is a non-negotiable issue. The following summary explains the necessary documentation requirements to help you navigate these expectations.


Notification About Documentation

Depending on the type of account, certain information is needed to approve a claim. You will need to submit the required documentation when you file a claim, or your claim cannot be approved. Should additional documentation be needed to process your claim, you will be sent a notification that there is outstanding documentation required. For HIPAA Privacy reasons, the email notice will not have details on the expense or the specific additional documentation required. The email simply alerts you to log in to the Vita Flex consumer portal and to check your account. Check the "Message Center" for details on what information is missing from the documentation submitted. 


Documentation Required When Using Your Debit Card

Many times, when you use your debit card to pay for an expense, you will still be required to submit documentation for your claim. This is often the case for expenses such as coinsurance, dental, and vision care expenses. In these cases, you will be sent a request for the documentation after the fact.

There are other debit card transactions that will not require documentation. For example, copays that have an exact dollar match to the copays on your health plan and purchasing eligible expenses from a qualified merchant do not require additional documentation.

If you ignore the request, or do not have the documentation to submit, your debit card will be deactivated until adequate documentation of the expense is provided, or until the expense is repaid to your account.


Health FSA Documentation

For a Health Flexible Spending Account (FSA), an Explanation of Benefits (EOB) is typically the best document for verifying your claim eligibility. The EOB almost always has all of the required information. Required elements for sufficient documentation include the following information:

  • Provider name

  • Patient's name

  • Date(s) of service/purchase date for items

  • Description of service/item purchased

  • Total amount charged

  • Insurance payment (if any)

You may submit claim documentation online at, via the mobile app, through email, or by the U.S. mail. When submitting a claim through email or U.S. mail, a completed and signed Health FSA Claim Form is also required. For more information on claim and documentation requirements, please see the Vita Flex Health FSA Claims Guide.


HRA Documentation

For a Health Reimbursement Account (HRA), the documentation that is required may depend on the type of claim you are incurring. For example, many HRA plans have a deductible limit that must be met prior to funds being paid out. When this is the case, documentation that you have met the deductible (most often in the form of an EOB) will be required. Please check your Plan Summary for your specific requirements. Plan Summaries can be found through the Vita Flex Portal.

Here are some general examples of the documentation required for expenses:

Medical Expenses – An Explanation of Benefits (EOB) from your insurance carrier.

Dental Expenses – A dental EOB (If you have dental insurance). If you do not have dental insurance, you would need an itemized statement that includes the following information: 

  • Provider name

  • Patient's name

  • Date(s) of service

  • Total amount charged

  • Description of service or item


Vision Expenses – An itemized statement that includes the following information: 

  • Provider name

  • Patient's name

  • Date(s) of service or purchase date for items

  • For online purchases, this would be the shipment date

  • Total amount charged

  • Insurance payment(s) (if any)

  • Description of service or item


Medical Travel - A collection of documents, receipts and statements including the following information:

  • Location Information

    • Home City

    • City where services are provided

  • Treatment Information

    • Diagnosis

    • Medical procedure code

  • Billing Information

    • Provide write-off amount (for PPO provider or courtesy discount)

    • Insurance payment amount

    • Net amount paid 

  • Transportation Expenses

    • Type of transportation (bus, train, airplane)

    • Departure city (must match home city)

    • Destination city (must match location where services are provided)

    • Date of transportation (must align with dates of service)

    • Transportation dates allow for one day on either side of medically necessary treatment plus necessary recovery time as specified by provider

    • Copy of receipt for all transportation expenses showing the above elements

    • Credit card receipts are not sufficient

    • Name of caregiver if applicable (must meet required caregiver/companion guidelines)

  • Lodging

    • Type of lodging

    • Lodging address (must match treatment location)

    • Date of lodging (must align with dates of service)

    • Lodging dates allow for one day on either side of medically necessary treatment plus necessary recovery time as specified by provider

    • Copy of receipt for lodging expenses showing the above elements

    • Credit card receipts are not sufficient

  • Attestation

    • Necessity of medical travel (service not available within a 50-mile radius of home)

    • Travel includes no component of personal enjoyment


HSA Documentation

For a Health Savings Account (HSA), Vita Flex does not require documentation to process distributions for claims. As the account holder, it is your responsibility to remain compliant with the IRS guidelines and make sure that account distributions are made for eligible expenses only.

Be sure to retain documentation for all HSA expenses. Even though you will not be asked to submit receipts, it is advised that you retain documentation of all expenses for which you make distributions (or reimbursements to yourself) from your HSA. Upon a tax audit by the IRS, you will be required to present this documentation. Vita Flex is not responsible for furnishing HSA claims documentation in the event of an IRS audit.


Dependent Care FSA Documentation

Dependent Care claims require the following information:

  • Name of the individual receiving care

  • Name of provider

  • Date(s) of care

  • Total amount charged


If the provider is not able to furnish a document with the required information, you may complete a Vita Flex Dependent Care Consolidated Claim Form. When this form is signed by the employee and the provider, it can stand as the sole documentation required. For more information on Dependent Care claim requirements, please see the Vita Flex Dependent Care Claims Guide.

Comments (0)