A medical expense claim is typically denied because the expense is not eligible, required documentation is missing, the service occurred outside the eligible reimbursement period, or additional information is needed to verify the claim.
How do I find the reason my claim was denied?
Log in to your Take Command account and review the claim details.
If additional information is needed, the denial notice will generally explain:
Why the claim was denied
What information is missing
Whether the claim can be resubmitted
Reason 1: The expense was submitted as a medical expense instead of a premium
Health insurance premiums and medical expenses are reviewed differently.
If a monthly insurance premium is submitted as a medical expense claim, the claim may be denied.
What should I do?
Submit the expense using the appropriate premium reimbursement process, if premiums are eligible under your plan.
Reason 2: The date of service occurred before your HRA became effective
Expenses are generally eligible only if the service was received after your HRA effective date.
Eligibility is based on the date of service, not:
The date you received the bill
The date you paid the bill
What should I do?
Verify the date of service and compare it to your HRA effective date.
Reason 3: The expense is not eligible for reimbursement
Not all healthcare-related expenses qualify for reimbursement.
Eligible expenses are generally determined by IRS rules and your employer's HRA plan design.
What should I do?
Review your plan rules and confirm that the expense is eligible before resubmitting.
Reason 4: The expense was submitted after the deadline
Some plans have deadlines for submitting expenses from a prior plan year.
Claims submitted after the applicable deadline may not be eligible for reimbursement.
What should I do?
Review your plan's claim submission deadlines and verify when the expense was incurred.
Reason 5: Required documentation was not provided
Claims must include documentation that supports the reimbursement request.
In some cases, additional documentation may be required, including a Letter of Medical Necessity.
What should I do?
Review the denial notice and upload any requested documents.
Reason 6: Required information is missing from the documentation
Documentation must contain enough information to verify the expense.
Required information typically includes:
Patient name
Provider, pharmacy, hospital, or merchant name
Date of service
Description of the service or item
Amount charged or paid
What should I do?
Submit updated documentation that contains all required information.
How do I know if an expense is eligible?
Eligibility depends on:
IRS reimbursement rules
Your employer's HRA plan design
The type of expense submitted
Review your plan documents or employee portal for plan-specific eligibility information.
Can I resubmit a denied claim?
In many cases, yes.
If the denial was caused by missing documentation, incorrect claim categorization, or incomplete information, you may be able to correct the issue and resubmit the claim.
Review the denial notice for specific instructions.
Key takeaway
Most denied medical expense claims are caused by missing documentation, ineligible expenses, incorrect claim types, or timing issues. Review the denial reason in your account and provide any requested information before resubmitting the claim.