When submitting a claim it is important to ensure that you are submitting under the correct category and subcategory, as well as submitting the appropriate documents along with your claim.

Depending on the expense being claimed, you will need to submit one of the following:

An Official Service Receipt: In order to approve a claim for a service related expense, we need to see the Official Service Receipt which will detail the following: patient name (Your name or the name of an eligible dependent listed under your account. Please ensure that the name presented on the receipt matches the name you or your dependent is presented as under your account.), practitioner's name and credentials, what services were provided, service date, charges and payment.
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An Official Prescription Receipt: In order to approve a claim related to prescribed medications, we need to see the Official Prescription Receipt. An Official Prescription Receipt will contain the following:

Please also ensure that in addition to submitting either the Official Service Receipt or Official Prescription Receipt, you have also submitted proof that the expense has been paid for as the official receipts may not always show this.

Immediately after a claim as been submitted, it enters Pending status. Pending status indicates that we have successfully received your claim and it has been sent into one our Adjudication queues to be assessed.

myHSA's turnaround time for the adjudication of claims is 1-3 days. Should an Adjudicator require any additional information from you in order to properly assess your claim, they will leave a note on the claim, and you should receive an email notifying you of this.

Although we take pride in our speedy adjudication process here at myHSA, there are occasions when our queues are particularly busy and it may take closer to 3 days to evaluate your claim. You may notice that from October to March in the New Year, claims may be in pending status longer than usual.

This particular status will only appear if you happen to be missing one or more of the documents previously mentioned under the "Claim Submission" portion of this article.

The Adjudicator who assessed your claim will leave a note informing you of what is missing, and, typically, you will have 7 days from the day the note was left to submit the missing information before the claim is ultimately denied.

Should you require more than 7 days to gather the required information, you can respond to the note with a memo of your own letting us know that you are getting the documents, and we can keep the claim pending for you!

Approved status will appear once your claim has been properly adjudicated, and it has been decided that the expense claimed meets the requirements for eligibility.

myHSA pays out claims every Wednesday or Friday immediately after claim approval (whichever comes first). On the payment date, you will see your claim status switches to "PAID" if you are using our app, and "Approved for Payment" if you are using our website.

Please note that it may take some time to show in your account. Some banks take longer than others to clear the funds. We typically say you should see reimbursement by the evening of the day of deposit or by the next day depending on your bank.

Unfortunately, should your claim's status switch over to Denied, this indicated that although your claim has been properly assessed by a member of our Adjudication Team, sadly your claim does not meet the requirements for eligibility.

A claim can be denied for a number of different reasons. Should you be interested in the 5 Common Claim Denial Reasons and How to Avoid Them, check out the article linked below!

5 Common Claim Denial Reasons and How to Avoid Them

Pictured below is a visual representation of a claim's life cycle!

Should you have any questions regarding myHSA's Claims & Adjudication process, speak with one of our amazing agents via live chat or via email at support@getmyhsa.com.

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