Important note: This only applies to Forma members who have FSA, LPFSA, DCFSA, Parking or Transit accounts.
If you make a purchase that is later determined to be ineligible, you owe the amount you spent back to the original pre-tax account. Your Pre-tax Forma Card (and any dependent cards) will be locked until the balance is repaid.
A balance due happens when there is:
- An ineligible card transaction
- An ineligible approved and paid claim
- An unsubstantiated card transaction (where a receipt was not provided within 90 days of the transaction date)
- The receipt submitted does not include all the required information
- Claimant name
- Vendor name
- Date of service
- Service name
- LMN (if applicable)
- Rx (if applicable)
- To learn more about what's required for DCFSA claims, refer to the article What documentation is needed for a DCFSA reimbursement claim?
If the documentation submitted is not sufficient, sometimes a Letter of Medical Necessity (LMN) is required. To determine if an item or service requires an LMN, refer to this link for a comprehensive eligibility list.
As you continue to file claims for eligible out-of-pocket spending, the ineligible amount will automatically be subtracted from your next reimbursements until the balance is repaid.
Important Note: A balance due cannot be cleared by direct payment. The only way to offset the balance is by submitting claims.
For example, say you made a $20 ineligible card transaction. Once the transaction is deemed ineligible, it will create a $20 balance due. Or, if you submit a $20 claim and it was approved and paid, and later on it was found to be ineligible, Forma will reverse the claim and create a balance due.
Submitting manual claims
Say you have a $20 balance due. You submit a claim for $120 after the balance due amount is created. When the $120 claim is approved, it will offset the $20 balance due, and you will be reimbursed $100.
Please note that all future claims following an ineligible transaction may be used to offset the balance due until it is fully paid off.
How can I tell if I owe a balance?
If you have a balance due on your pre-tax accounts, you will see it appear in multiple places on Forma.
- Your Forma homepage:
When you log in to Forma, you will see a callout under your pre-tax account on the homepage. It will display how much you owe back to your account.
- On the Homepage under "tasks":
- When filing a new claim, on the claim submission success page, you will see the following message highlighted in orange:
- On the account details page:
You'll see a banner detailing the amount you owe back to your account:
- On the Pre-tax Forma Card settings page:
- When filing a new claim:
- On the transactions details page:
This can be accessed from the Balance Due table at the bottom of the account details page.