How do I submit a claim for reimbursement?
If you cannot use your MyFlex Advantage Card to pay for an expense, use your own funds to make the payment, and then submit a completed claim to UPMC Health Plan for reimbursement.

For the fastest turnaround, use the Online Claims Submission (OCS). Fill out the required form and list all necessary information. Once your claim is completed, print the Substantiation Cover Sheet, attach your receipts, and fax both to UPMC Health Plan.

You also may submit a claim manually by downloading the appropriate claim form. Complete the claim form, attach your receipts, and either fax, email, or send the information in the mail. UPMC Health Plan will review your claim and send your reimbursement via check or direct deposit (if available).

When will I receive my reimbursement check?

Typically, it takes 3 to 5 business days to be reimbursed for claims submitted through OCS. Manually submitted claims require 7 to 10 days to process. It is important to ensure that your claim form contains all of the required information. Direct Deposit is also available and can allow you to receive your reimbursement within 2 to 3 business days after your claim is processed. You can indicate on your claim form if you would like to receive your reimbursement via direct deposit by providing your account details in the Reimbursement Information section of the claim form. You may also complete a Direct Deposit Authorization Form and submit it at any time.

What if my claim is denied?

Claims will be returned within 7 business days of receipt if not all of the required information is included. Cancelled checks, credit card receipts, or receipts that only show a balance due are not sufficient and will not be accepted as valid documentation to support a claim.

How do I substantiate an expense?

Flexible Spending Accounts are regulated by the IRS. While many expenses paid with your MyFlex Advantage card may automatically be approved, others may require documentation in order to comply with IRS regulations. If requested, please submit a receipt containing the following:

• Date of service/item purchase
• Description of service/item
• Provider/merchant name
• Name of person receiving services
• Amount you are required to pay