Skip to main content
Horizon CDH Learning Site

Submitting Receipts and Documentation for Debit Card Purchases

This article explains why you may be asked to provide a receipt or additional information about a medical expense you paid for with your debit card, and provides instructions for sending that information to us.

Overview

After paying for an expense with your debit card, you may be asked to provide

UndefinedNameError: reference to undefined name 'companyname' (click for details)
Callstack:
    at (Individuals/Debit_Cards/Submitting_Receipts_and_Documentation_for_Debit_Card_Purchases), /content/body/div[1]/p[1]/span, line 1, column 1
with a receipt or additional documentation.

The

UndefinedNameError: reference to undefined name 'debit' (click for details)
Callstack:
    at (Individuals/Debit_Cards/Submitting_Receipts_and_Documentation_for_Debit_Card_Purchases), /content/body/div[1]/p[2]/span, line 1, column 1
can be used at all authorized medical providers. Most providers supply products and services that are known to be eligible medical products and services. When you buy a product or service from a provider in this category, medical claims are approved immediately and don't require any further documentation. 

Some providers sell both eligible and ineligible products and services, e.g., dermatology and counseling services.  When using your debit card with this type of provider, the debit card is accepted when you pay, but

UndefinedNameError: reference to undefined name 'companyname' (click for details)
Callstack:
    at (Individuals/Debit_Cards/Submitting_Receipts_and_Documentation_for_Debit_Card_Purchases), /content/body/div[1]/p[3]/span, line 1, column 1
may request more information about the expense. 

See Eligible Expenses for a searchable list of eligible medical expenses.

Examples of documentation that may be requested

  • A valid prescription
  • A Letter of Medical Necessity
  • An Explanation of Benefits (EOB) from your insurance company 
  • An itemized statement or receipt that shows the following:
    • Service received or product purchased
    • Name of provider or merchant
    • Dollar amount
    • Date of service or sale

Submitting documentation for your expense

There are four ways for you to send the requested documentation to

UndefinedNameError: reference to undefined name 'companyname' (click for details)
Callstack:
    at (Individuals/Debit_Cards/Submitting_Receipts_and_Documentation_for_Debit_Card_Purchases), /content/body/div[3]/p/span, line 1, column 1
:

  • Online at
    UndefinedNameError: reference to undefined name 'Main_site_URL' (click for details)
    Callstack:
        at (Individuals/Debit_Cards/Submitting_Receipts_and_Documentation_for_Debit_Card_Purchases), /content/body/div[3]/ul/li[1]/span, line 1, column 1
    
  • Email
  • Fax
  • Mail 

Submitting documentation for your expense on
UndefinedNameError: reference to undefined name 'Main_site_URL' (click for details)
Callstack:
    at (Individuals/Debit_Cards/Submitting_Receipts_and_Documentation_for_Debit_Card_Purchases), /content/body/div[3]/div[1]/h3/span, line 1, column 1
 

Follow the steps below to submit documentation for your expense on

UndefinedNameError: reference to undefined name 'Main_site_URL' (click for details)
Callstack:
    at (Individuals/Debit_Cards/Submitting_Receipts_and_Documentation_for_Debit_Card_Purchases), /content/body/div[3]/div[1]/p/span, line 1, column 1
.

  1. UndefinedNameError: reference to undefined name 'Sign_in_steps' (click for details)
    Callstack:
        at (Individuals/Debit_Cards/Submitting_Receipts_and_Documentation_for_Debit_Card_Purchases), /content/body/div[3]/div[1]/ol/li[1]/span, line 1, column 1
    
     
  2. A notification is displayed on your account home page when there's a claim that requires documentation. Click on the Go to Claims Summary button in the notification.
  3. Select the appropriate account from the Account drop-down menu.
  4. In the Debit Card Claims Requiring Documentation section, click on Needs Receipt link next to the claim you want to provide documentation for.
  5. Click on Upload Documentation.
  6. Click on Choose File.
  7. Select the file you wish to upload and click on Open.
  8. Click Continue.
  9. Review your request to make sure it's correct.
  10. Click Submit.

Submitting documentation for your expense by email, fax, or mail

Follow the steps below to submit documentation for your expense by email, fax, or mail.  

  1. UndefinedNameError: reference to undefined name 'Sign_in_steps' (click for details)
    Callstack:
        at (Individuals/Debit_Cards/Submitting_Receipts_and_Documentation_for_Debit_Card_Purchases), /content/body/div[3]/div[2]/ol/li[1]/span, line 1, column 1
    
  2. A notification is displayed on your account home page when there's a claim that requires more documentation. Click on the Go to Claims Summary button in the notification.
  3. Select the appropriate account from the Account drop-down menu.
  4. In the Debit Card Claims Requiring Documentation section, click on Needs Receipt link next to the claim you want to provide documentation for.
  5. Click on Print Form.  
  6. Fill out the form.
  7. Use one of the following methods:
    • To send by email: Send the completed form and requested documentation to
      UndefinedNameError: reference to undefined name 'forms_email' (click for details)
      Callstack:
          at (Individuals/Debit_Cards/Submitting_Receipts_and_Documentation_for_Debit_Card_Purchases), /content/body/div[3]/div[2]/ol/li[7]/ul/li[1]/span, line 1, column 1
      
      .
    • To send by fax: Fax the completed form the form and requested documentation to
      UndefinedNameError: reference to undefined name 'group_fax' (click for details)
      Callstack:
          at (Individuals/Debit_Cards/Submitting_Receipts_and_Documentation_for_Debit_Card_Purchases), /content/body/div[3]/div[2]/ol/li[7]/ul/li[2]/span, line 1, column 1
      
      .
    • To send by mail: Send the completed form and requested documentation to:
      UndefinedNameError: reference to undefined name 'companyname' (click for details)
      Callstack:
          at (Individuals/Debit_Cards/Submitting_Receipts_and_Documentation_for_Debit_Card_Purchases), /content/body/div[3]/div[2]/ol/li[7]/ul/li[3]/span[1], line 1, column 1
      
      UndefinedNameError: reference to undefined name 'companyaddress' (click for details)
      Callstack:
          at (Individuals/Debit_Cards/Submitting_Receipts_and_Documentation_for_Debit_Card_Purchases), /content/body/div[3]/div[2]/ol/li[7]/ul/li[3]/span[2], line 1, column 1