Many of our clients have Customers who need an FSA (Flexible Spending Account) or Dependent Care Report. Most FSA/Dependent Care Reports require the following information:
Provider Name (Company name), address, and Tax ID
Participant Name (Account Holder/Parent)
Dependents Name(s) (Enrollee/Child)
Service Dates of Care Provided
Type of Service
Total Amount of Fees per Dependent/Enrollee
Signature of Director/Admin
There are two possible ways to create one of these reports with most, if not all, of the above information:
Add Dates of Service to Invoicing/Print Transaction Statement
Create a Dependent Care Form and upload it as an E-signature Document
See below for more details on these two methods.
Dates of Service/Transaction Statement
The first and most used method involves adding "Dates of Service" to your Invoices so that they appear on Transaction Statements. Follow the steps below to print a Dependent Care report this way.
NOTE: If you add Dates of Service in Invoicing after enrollment, the Date of Service will not be visible on invoices that have already been processed. You would need to add the Dates of Service manually in the comments section of the Invoice(s). Skip to Add Comments below to learn how to do this.
Step 1 - Add Dates of Service
First, you will have to add "Dates of Service" to your Invoicing. This will be on EACH Payment Plan/Payment Events within EACH Enrollment Period.
See this support article for detailed steps to add Dates of Service to Invoicing.
The "Dates of Service" comment will show up in the Customer's Transaction History like this (based on the above example):
Step 2 - Print a Transaction Statement
The next step is to print the Transaction Statement from the Customer's Billing page.
Click the print icon and "Print Statement" at the top-right of the Transaction History. Select the desired date range and click "Load" then "Print." Send the statement either to a printer or save it as a PDF to email.
Add Comments to Transactions
Add Comments to Transactions
If you added "Dates of Service" AFTER the transactions have been posted, then you will need to add them as comments to EACH transaction. You can add one of these comments:
Public (meaning the customer can view the comment in the Customer Portal)
Private (meaning the comment is internal-only viewable by an Admin User).
There are multiple ways to do this:
Add Current Invoice
By clicking on + Add current invoice under a Customer's Payment Plan (on the Billing page), add a public or private comment with dates of service.
Invoices Detail
On the Invoices page, click on "Details" beside an Invoice. Click on the three dots on any line item, then on "Edit." Add a public or private comment with dates of service.
Transactions Window
Click on "Transactions" in the left-hand menu. A window will open where you can enter a charge, payment, refund, or credit. Add a public or private comment with dates of service.
Edit Existing Transaction
You can also click on the three dots on any line item in the Transaction History to edit the existing transaction. The edit Transaction window looks just like the Post Transaction window. Add a public or private comment with dates of service and click Save.
Dependent Care Receipt E-signature Document
The second way to create a Dependent/FSA receipt is to use our E-signature feature. You can download a PDF of a dependent care receipt form.
NOTE: E-signatures cost $2.50 per signature request. A signature request is when someone prepares a document, sends it out for someone to sign, and collects it back. Whether the request has been fully signed or partially signed, it will still be counted as one signature request transaction.
Here is a template you can copy and use: Dependent Care Receipt. It looks like the example below, which you can edit to make your own.
Step 1 - Field IDs
If you want to send the form to the Account Holder (parent/guardian), you may want to automatically map in fields from the Enroll Form. You will see the fields from the Enroll Form Editor (where you edit your Enroll Form) on the left side. On the right are the words as you will see them in the Designer (where you place fields on the Document).
If you want the exact wording as is on the left, click the Fill button, and it will be added to the right (you’ll see a checkmark with a circle appear). Once you have the fields as you want them, click Next.
Step 2 - Setup
Under Setup, click on Upload Document to upload the Document from your computer. Under the Setup section enter the following information:
Title - On the right, put your Title (you can change this later).
Required At - Select whether this Document is required at the Primary Account Holder, Enrollee, or Enrollment level
Expiration - leave blank
Redirect URL - You can also add a custom URL (website) to which you want those who sign to be directed when the signing process is over. The default is the Customer App home page.
Signers - Decide on whether you need a parent's signature. If you do, leave the signer type at “Primary Account Holder/Parent.” You can also use "Typed Email" for a provider (admin user) signature. Here you type in the email address you want the document to be emailed to.
Step 3 - Design
If you want any fields to be mapped, use the "Sender" fields (pink fields). If you want the signer to fill out the fields (i.e., the provider), then use the "Signer" fields (blue fields). See this article for more steps on how to design an E-signature Document.
Step 4 - Send Test
In this step, search for ANY existing Account via Enrollee or Account Holder name that has enough filled-out information for you to test. This can be ANY active Account; the Document will NOT be sent to the Account Holder/Signer(s). Enter the email address you would like to receive the Test Document (this can be your own). Click "Send Test."
Check the email address you sent the test to for an email with this subject line:
"[Company Name] [Document Name] - Signature requested by Enrollsy.com." The sender will be noreply@mail.hellosign.com. Click on the "Review & Sign" button. Click OK, then "Get Started" to go through the Document as a customer would.
If you have any changes that need to be made, open the Design Editor to make the changes. Save the template (you can send another test at this time; you can send as many test Documents as you wish).