Why has my employees claim been selected for an audit and how do they get it completed?
We audit 10% of all claims submitted online throughout the day. Our system selects the claim for an audit after it has been submitted and then you receive a notice that the claim is being audited. In the notice you will be advised how to submit your receipts, typically sent via fax or email. Please be aware that you will not be able to submit any claims until the audit has been completed.
When we are reviewing your original receipts, we look for the following:
Date and type of service
Cost of service & Proof of Payment. Proof of payment can be in the form of a debit or credit slip, cash register receipt, credit or bank statement.
Qualifications and registration numbers of Service Provider (ex: RMT, MD. ND etc.). If you are visiting a chiropractor, dentist or other practitioner, we require their registration number in order to process your claim.
We confirm that the amount claimed is within your predetermined annual expense limit at the time of service and confirm the eligibility of the patient at the time of the service. We determine if the claim has been submitted within the allotted filing period after year end. For some, this may be 365 days but for others, it may only be 30 days or less.
Finally, we ensure that the expense is eligible. A list of eligible expenses is available through your personal portal of MyOlympia
Once we have reviewed your receipts, we will complete the audit and reimbursement of your claim will be processed.
We recommend having all your receipts on hand when you are submitting your claim for both audit purposes and for your own records. If you do not have your receipt and you are selected for an audit, you can contact your service provider and they will be able to provide you a duplicate copy.