Moving from Substantiation Service to Self-Substantiation

Many insurance carriers have recently enhanced their website security by adopting more stringent user login and credentialing requirements. As a result, Choice Strategies, a division of WageWorks, Inc. is no longer permitted to log in to these websites on behalf of participants enrolled in our Substantiation Service to substantiate certain claims and card transactions. Accordingly, Choice Strategies will discontinue our Substantiation Service effective September 1, 2016. Thereafter, participants who have enrolled in this service will now be required to submit supporting documentation to Choice Strategies to verify the eligibility of certain claims and card transactions under their plans.

What does this mean for our participants?

For transactions received on or after September 1, 2016, a participant may be asked to provide Choice Strategies with supporting documentation to substantiate the eligibility of certain claims and card transactions for reimbursement. The requested documentation will enable Choice Strategies to verify that the expense is eligible under the applicable plan.

For transactions received prior to September 1, 2016, Choice Strategies will continue to attempt to substantiate a claim or card transaction on behalf of an enrolled participant, to the extent permitted. If Choice Strategies is unable to do so, we will reach out to the participant and request the necessary supporting documentation.

To help participants with this change, we have provided the following frequently asked questions.

Q. What is Substantiation?

A.  Substantiation is the process of verifying that a purchase made either with a Choice Strategies Card or submitted to Choice Strategies for manual reimbursement is an eligible expense under the applicable plan. Substantiation is required in order for a plan to maintain a qualified (tax-free) status. Please note that not all card transactions or claims require this verification.

Q. I enrolled in Choice Strategies’ Substantiation Service. Why am I now being asked to provide documentation to substantiate my reimbursement claim or card transaction?

A.  Many insurance carriers have implemented a two-step verification process for website users to enhance website security. This verification process requires each user to enter (1) a password, and (2) a unique verification code, each time a user logs in to the website. The verification code is specific to a user’s account, changes each time a user attempts to log in, and is sent directly to the user’s designated email address.

As a result, Choice Strategies does not have the ability to receive the unique verification code on behalf of a participant in order to complete the login process. Accordingly, Choice Strategies is no longer able to support the prior substantiation process. This means you will now be responsible to submit documentation necessary for Choice Strategies to substantiate the eligibility of certain expenses, and Choice Strategies will only be able to pay claims or verify certain card transactions that have been substantiated by you.

Q. How do I know if I need to submit documentation for a claim or card transaction?

A.  You will receive notification from Choice Strategies via your online account at www.choice-strategies.com, as well as by email or mail. This notice will explain that further documentation is required to substantiate your claim or card transaction.

Q. How do I submit substantiation documentation?

A.  You will need to obtain the Explanation of Benefits (EOB) for your claim or card transaction directly from your insurance carrier, either by logging in to the insurance carrier’s website or by requesting a copy from the insurance carrier by mail. Once you have a copy of the EOB, simply submit it to Choice Strategies by one of the following methods:

1)     Submit the EOB online by logging in to your account at www.choice-strategies.com

2)     Take a photo of the EOB and submit it via our free Mobile App

3)     Mail the EOB and completed Claim Form to:

Choice Strategies
PO Box 2205
South Burlington, VT 05407

 4)     Fax the EOB and a completed Claim Form to 1-877-723-0148

Claim Forms are available on the Member Forms page at www.choice-strategies.com.

Q. Where can I find out more about this process?

Visit choice-strategies.com/member-faqs to learn more about online account access and requests for documentation. A video explaining the documentation needed to substantiate claims is available here