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5 Common Claim Denial Reasons and How to Avoid Them
5 Common Claim Denial Reasons and How to Avoid Them

Has your claim been denied? One of the 5 scenarios below may be the reason why.

April avatar
Written by April
Updated over 2 months ago

The Name on your Invoice Doesn’t Match the Name Associated with your Account

HSAs are personal accounts, and claims are generally limited to the account holder and their eligible dependents. If the name on your invoice doesn’t match the name on the HSA account, or if the expense was incurred by someone who isn’t an eligible dependent, the claim will likely be denied.

How to Avoid It:

  • Ensure that the name on the invoice matches the name associated with the HSA account or that of an eligible dependent.

  • Review your HSA guidelines to ensure your dependents are correctly listed and that their expenses are covered under your account.

  • If the service provider made a mistake on the invoice, request a corrected document with the right name before submitting the claim.

In the event that you have recently changed your name or happen to go by a middle or preferred name, please reach out to us via live chat or email us at support@getmyhsa.com, and we'd be more than happy to assist!

The Date of the Expense being Claimed is Outside of your Benefit Period

One of the most frequent reasons for claim denial is that the date of the expense falls outside your HSA's eligible benefit period. Most HSAs only allow claims for expenses incurred after the account was opened and during the current benefit year.

How to Avoid It:

  • Always check the service date on your receipt or invoice before submitting the claim to ensure it falls within the benefit period.

  • Make sure to review your plan's specific guidelines regarding eligible dates and avoid submitting expenses from a previous benefit year unless explicitly allowed by myHSA.

  • Keep a detailed record of when your HSA was activated and when your benefit year starts and ends.

The Claim is Missing the Official Service Receipt

Another common reason for denial is submitting a claim without an official service receipt. myHSA Adjudicators need documentation that clearly states your name, the date, the service(s) provided, and the amount charged to verify the validity of the expense.

How to Avoid It:

  • Always attach a detailed receipt that lists the service or product, date of the expense, and provider details.

  • Avoid using generic transaction records, like credit card statements, as these do not typically contain the required level of detail.

  • Contact the service provider for an official receipt if you don’t already have one on hand.

You’ve Attached an Invoice that was Previously Used in Another Claim

Submitting the same invoice or receipt for more than one claim is a common mistake that can lead to denial. This can happen if you’re attempting to split a single expense across multiple claims, which some HSAs do not allow.

How to Avoid It:

  • Track which invoices and receipts you’ve already submitted with your claims.

  • Make sure to avoid submitting the same documentation for multiple claims without leaving a note explaining why you are doing so.

  • If you need to split a large expense over time, ask us via email or live chat how to properly document this to avoid rejection.

The Expense Unfortunately Just isn’t Eligible Under HSA

Not all medical expenses are eligible for reimbursement under HSA guidelines. For instance, cosmetic procedures, certain over-the-counter medications, and non-prescribed supplements typically do not qualify as eligible medical expenses.

How to Avoid It:

  • Familiarize yourself with the list of eligible expenses provided by myHSA. Common eligible expenses include co-pays, prescription medications, dental and vision care, and hospital services.

  • If you’re unsure about the eligibility of a certain expense, ask us via email or live chat before submitting the claim to avoid unnecessary delays.

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