Are there any administrators that do not accept updated LMNs or documentation after an initial denial?

Most Health Savings Account (HSA) and Flexible Spending Account (FSA) administrators permit the submission of updated documentation, such as a revised Letter of Medical Necessity (LMN), following an initial claim denial. However, policies can vary, and some administrators may have restrictions or specific procedures regarding the acceptance of additional documentation after a denial.

For FSAs, administrators like FSAFEDS allow multiple levels of appeal, during which you can submit new or updated documentation:

• First-Level Appeal: Submit a written appeal within 60 days of the initial denial, including any supporting documents like an updated LMN.

• Second-Level Appeal: If the first appeal is denied, you have an additional 30 days to submit a second appeal with further documentation.

• Final Appeal: A third-level appeal can be filed within 30 days of the second denial, which will be reviewed by an independent third party.

These stages provide opportunities to present new information that may support your claim.

HSA administrators, such as Bank of America and HealthEquity, typically allow resubmission of claims with updated documentation:

• Bank of America: If you receive a denial, you can resubmit your claim for review with updated documentation, including a Medical Necessity Form if applicable. Bank of America

• HealthEquity: Some denied claims require additional documentation, which you can submit through your online account for reconsideration.

• Timelines: Be aware of specific deadlines for submitting appeals or additional documentation, which can vary by administrator.

• Documentation Requirements: Ensure that any updated LMNs or other documents meet the specific criteria set by your plan administrator.

• Administrator Policies: Some administrators may have strict policies regarding the acceptance of new documentation after a denial. It's essential to review your plan's guidelines or contact your administrator directly to understand their procedures.

If you need assistance understanding your plan's appeal process or preparing updated documentation, consider reaching out to your plan administrator or benefits counselor for guidance.