- Report: #194080
Complaint Review: AFLAC - Frederick Maryland
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AFLAC
Aflac.com Frederick, 21701 Maryland, U.S.A.
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AFLAC ripoff delays reimbursements from flexible spending accounts Frederick Maryland
We switched to AFLAC this year for our flexible spending accounts and what a nightmare! They have returned over 50% of my requests for reimbursement for the stupidest and deliberately onorous reasons delaying payment. Doctor Visit is too vague--you must tell them the reason, amount charged, and give them the insurance form showing the insurance company did not cover the copayment. Give me a break! That way you have to wait 1-3 weeks for it to be billed, then another 1-3 weeks for the claim to be processed, then wait for it to be mailed then submit it. ANYONE ELSE takes your receipt of the copayment to reimburse it when you spend the money! But this way AFLAC can earn interest on it for the 4-8 weeks it takes for it to go through the insurance!
Dependent care is even worse! I have spoken to the IRS on several ocassions in regard to dependent care accounts. They confirmed that dependent care expenses are eligible for reimbursement when the expense is PAID (i.e. incurred). Section 125 of the IRC says that the expense is eligible for reimbursement when it is incurred. There is a statement in the code that expenses are eligible for reimbursement upon the date of service. It is an either or statement not an excuse (this is the word the IRS Taxpayers Advocacy used ) not to pay the claim when the expense is INCURRED. It is a common and acceptable accounting procedure to pay dependent care expenses upon proof of payment (i.e. a receipt).
Well, the employee says AFLAC doesn't do it that way and you can't get reimbursed until after the service is provided. Basically, tough. I told them I was filing a complaint and they said feel free. What great customer service huh!
So all the summer camps you have to pay in March won't get reimbursed until months later in the summer. What a deal!! In 8 years with other companies (benisource last year for example) this has never happened before.
I had such a positive view of AFLAC and was actually happy when I heard we had switched to them. What a huge disappointment! I will not be signing up for this "benefit" next year. Benisource might have taken longer at times but at least I didn't have to jump through hoops and provide tons of extraneous and unnecessary documentation every time I needed to be reimbursed!
Wendy
Frederick, Maryland
U.S.A.
Dependent care is even worse! I have spoken to the IRS on several ocassions in regard to dependent care accounts. They confirmed that dependent care expenses are eligible for reimbursement when the expense is PAID (i.e. incurred). Section 125 of the IRC says that the expense is eligible for reimbursement when it is incurred. There is a statement in the code that expenses are eligible for reimbursement upon the date of service. It is an either or statement not an excuse (this is the word the IRS Taxpayers Advocacy used ) not to pay the claim when the expense is INCURRED. It is a common and acceptable accounting procedure to pay dependent care expenses upon proof of payment (i.e. a receipt).
Well, the employee says AFLAC doesn't do it that way and you can't get reimbursed until after the service is provided. Basically, tough. I told them I was filing a complaint and they said feel free. What great customer service huh!
So all the summer camps you have to pay in March won't get reimbursed until months later in the summer. What a deal!! In 8 years with other companies (benisource last year for example) this has never happened before.
I had such a positive view of AFLAC and was actually happy when I heard we had switched to them. What a huge disappointment! I will not be signing up for this "benefit" next year. Benisource might have taken longer at times but at least I didn't have to jump through hoops and provide tons of extraneous and unnecessary documentation every time I needed to be reimbursed!
Wendy
Frederick, Maryland
U.S.A.
1 Updates & Rebuttals
cj
Birmingham,Alabama,
U.S.A.
Concerned Employee - things to expedite your claims processing and stop those pesky denials.
#2UPDATE Employee
Thu, June 29, 2006
Wendy,
I'm sorry to hear that you are having problems with your account with Aflac. I'll try my best to let you know some things to expedite your claims processing and stop those pesky denials.
First thing I'd like to address is the turn around time. If you are mailing your claim form in, this slows the process down. It takes the time to reach us via mail, and considering you're in Maryland I'd assume 3-4 days. If you fax (# 1-877-353-9256) it in, it will go directly into our queue. Once it reaches us it goes into queue (first in, first out) which normally does not take more than 2 days to process. During the end of the year it takes longer as we receive many more claims than usual b/c of people waiting till the last minute. Also, I'd suggest signing up for direct deposit. This will cut down on the time it takes to receive your check.
Next I'd like to address your denials. It looks like you are getting "Missing Receipt Information (MRI)" denials. If you go to the doctor for whatever reason, and you pay a copayment, ask them for you to give you a receipt which states it is a copayment. We need to have the Providers name, amount charged, service provided (or "copayment"), date of service, and person who incurred charges (I.E. your name).
For the DDC care, I'd like to explain there is a difference from date paid and date incurred. Incurred means the service has actually been provided (i.e. if you are sending your child to summer camp, they will have to have already attended, or close to the date.). The reason the IRS made this law (I'd assume) would be to stop people from signing up for a $1,000 session, then cancelling prior to going, and being reimbursed via the receipt.
With that addressed, I'll try to explain a few other things. You mentioned the fact that "Doctor Visit" was too vague. By IRS law, we can only reimburse you for care which is medically necessary (I.E. not cosmetic). We do not need the insurance in many cases. If it is a copayment which you pay at the time of visit, ask them to specify that on the receipt. This will suffice.
We also do not make any "interest" on claims being being denied, approved, or anything of the like. Also, processors do not make more money denying or approving claims.
As for the customer service, I hope this was just a misunderstanding. The company takes great pride in it's employees. The representative said go ahead and file a complaint as there is only so much we can do within the guidelines of the IRS. If it was an error on our part, I do apologize. Hope your claims processing goes smoothly in the future and you continue to do business with Aflac.
- An understanding employee
If you have any more problems or concerns, please feel free to respond as I'll make sure to look back on this time to time. :)
