We Are Deep In the Heart of Texas

Nomadic seasons of farming adventures with nature thrown in to include; a pinch of family, snippets of friends, counting our blessings, paying IT forward, home school, and the spicy things I decide to rant about.







Wednesday, February 17, 2010

I got a bit terse with FSAFeds via email

Let's see, we looked forward this year to using this Flexible Spending Account since, Saenz has chronic allergies.  So we have to fill out paper work and fax the forms but guess what?  Forms get lost -- lets tally at least the six times of missing paper work in 6 weeks:

1.  Second claim -- missing
2.  Letter Of Medical Necessity missing needed for first claim -- DENIED: not the right form had to be accomplished.
3.  HIPPA letter -- missing adding myself to hubby's acct
4.  LETTER of MEDICAL NECESSITY (LMN) FORM -- Missing on other claims denied
5.  HIPPA Letter resent, I can talk to folks.... YEAH FOR ME, bad for them
6. ANOTHER EMAIL, LMN not needed for OTC, what I thought the form was lost?

So, my email as I sent it to them.

To Whomever is Our Case Worker,

And with all due respect; please print this out for our case file...................

   Personally, This round and round over what is and what is not allowed is perfectly spelled out in the website. We know what is allowed for Saenz's Allergy treatment. However, one or two of your employees does not know or has not read the tables found on your (FSAFeds) website. Not only have your agents (case workers) have lost our paperwork numerous times creating 'due burden to the public --- Torres Family' which is against the Paperwork Reduction Act US CODE Title 44 but, have denied reimbursement for:

" Allergy Products - HCFSA Potentially Eligible ExpensePRINT THIS PAGE

Eligible expenses include products and home improvements to treat severe allergies. Examples include:
Electro-static air purifier
HEPA furnace filters and HEPA vacuum cleaner filters (only the difference in cost of the HEPA product minus the standard product can be reimbursed.) (waiting to submit - due to the repeated denials for claims)
Humidifier (future purchase)
Home/automobile air conditioners
Special vacuum cleaners for persons with respiratory problems (only the difference in cost of the special vacuum cleaner minus a standard vacuum can be reimbursed)
Special pillow cases, mattress covers, or other bedding barriers that provide protection against allergens to alleviate an allergic (DENIED though LMN was given and claims submitted in January 2010 and will be submitted again.)

condition "Note: See CAPITAL EXPENSES for important information and guidance."

   Another point: As I know not all OTC items such as Saenz's Eucerin/Aquaphor may or may not be allowed for his CHRONIC ALLERGY condition that still needs MEDICAL attention and was prescribed by a doctor with a letter of medical necessity. Special note should be given that Saenz is a dependent child, under the age of 13, with special needs...................

Found in the JUKEBOX on the FSAFeds website

" HEALING OINTMENTSHCFSA X Examples include:

Aquaphor by Eucerin For more information, see the OTC QRG.

   Next, we will be getting our carpeting replaced and tile installed. I do understand, that carpet removal will not increase our home's value (capital expense) -- the tile will thus, will only be submitting the form for carpet removal.


Another point to make this may also be allowed by definition with the LMN given by the allergist.

HUMIDIFIERSHCFSA X See ALLERGY PRODUCTS AND MITIGATION, CAPITAL EXPENSES

Next item we will be providing a form and reciept for:

NASAL STRIPS HCFSAX Nasal strips or sprays that are used to alleviate snoring or reduce nasal congestion are eligible for reimbursement from your HCFSA. Examples include:

Afrin Nasal Spray, Breathe Right, Dristan Nasal Spray, Snorezz

Please refer to OTC Quick Reference Guide.

To see other expenses that are eligible for reimbursement from FSAFEDS, please visit the Eligible Expenses Juke Box.

    And when is the FSAFeds Debit Card program going to be implemented? Seriously, this program would just eliminate the constant flow of paper back and forth, would fit in the goverments' TITLE 44, eliminate the need to waste paper, loss of paper records along with following guidelines with the four Rs mandated by federal government.


   Lastly, with all this added 'leg work and resubmission' your employees have also angered our sons Alergy Specialist Dr, Stafford to the point where he answered FSAFeds inquiry with a sharp retort not commonly found from a medical professional. And I may add, all this second guessing is bascially calling myself (MALISSA & GILBERT TORRES) thieves when in fact, the monies deposited into the FSAFeds are being put there by my husband Gilbert. So, if this email correspondence has caused alarm, I apologize on one hand.
 However, on the other I dislike being called dishonest by faceless government employees who have made an assumption that I have not thoroughly read FSAFeds website, policies, regulations on what is and what is not allowed. So please forward our case to a supervisor....



Respectfully,
Malissa Torres,
USAF RET

1 comment:

Unknown said...

Omg! I thought I was the only one going crazy with FSAFeds. It is 2014 and I am going round and round over replacing my sons Ortho retainer. Thank you for posting this.