I hate PayFlex

PayFlex can s_ck it

from JoeUser Forums

Argh!!  I really, really, really hate (and I hate to use that word as I try not to have hatred for others) the chuckleheads at PayFlex USA.  What a bunch of frackin' idjits they are there.

I've been fighting -- over the last 2 months (give or take) -- requests that they sent me to provide additional documentation for dental work done back in May.  They demanded supporting documentation for work that was done and I provided the supporting documentation they asked for, but it seems that in doing so I may have provided too much documentation.

They demand *either* an EOB (or EODB) -- Explanation of Benefits, or Explanation of Dental Benefits -- or itemized receipts for the work that was done and is in question.  So, stupidly, I submitted both items and unfortunately it seems they couldn't be bothered to look at anything more than just the EODB since I had submitted both items.  The EODB is apparently not completely currently as the Dentist's office and the insurance company argue a bit over work that was done and should be (and I'm sure will eventually be paid for).  Meanwhile the Dentist's office has been paid thanks to my usually handy-dandy, trusty little PayFlex card.  The PayFlex card takes my Flexible Spending Account money directly from the FSA and pays it via a "VISA" card directly over to the service provider/vendor.  Use of the card is loaded with a bunch of restrictions -- which I know and follow/honor -- and in the end it almost makes the card too much trouble to even use :(

Anyway, I'm trying, for about the 4th time to clear the log-jam with PayFlex by sending them another copy of the documentation that they requested.  The same documentation that I sent them a bunch of times already.  This time I've made it (hopefully) braindead simple for PayFlex -- I sent in *only* the detailed/itemized receipts for the services that were performed.  Not the EODB.  So, they have the supporting documentation they say they want and will accept and only that documentation.  In the future I may *never* send them another EOB or EODB since it seems they are completely clueless at looking at the rest of the documentation they get sent if I send in such things.  Maybe, just maybe, they'll get a clue and release the hold they've put on my account.  If not then I wish many poxes on their house(s).  Bastages.

9,436 views 5 replies
Reply #1 from JoeUser Forums Top

Geez!  I feel lucky!  We have an FMSA through a firm out of florida.  Several years ago I needed a crown and found I could get it done in Mexico (near where we were visiting my in-laws) for a fraction of the cost of locally, so I called them and asked them would they reimburse?  Sure, just have the doctor write up a detailed Bill.  So I did - and they paid it no questions!  Then my wife had about 7k or dental work done there (over 2 years - implants) and they paid!  No hassle! (the same procedures here would have cost us about $20k).

It is your money after all!  I am glad we have the firm out of Florida and not payFlex! I get my reimbursement within 2 weeks of sending in my claim.

Reply #2 from JoeUser Forums Top

It is your money after all! I am glad we have the firm out of Florida and not payFlex! I get my reimbursement within 2 weeks of sending in my claim.

The sad thing is that when the PayFlex card works it's incredibly simple and easy... until.... until!!! they demand to see copies of the detailed receipts or EOB because your name came up in the random "we want to be a P-I-T-A and demand documentation" audit list.  At that point it becomes, well, a P-I-T-A and not so simple and painless.

Most of the time it is fairly painless, but when they do demand the documentation they are so clueless about it that they become useless.

Over the last year and a half (just about) they've been a pain over about $350 - $750 of expenses.  The rest have flown through without much issue (going by my at times faulty memory, so the numbers could be off and they may have harassed me over more than the amount I'm thinking of).  In the end things will work out as I'll just pay a bunch of other medical expenses with checks and then submit for reimbursement and get paid back for same.  It's not like the amount that I have deducted and held each year is more than what the expenses are as the expenses are always more than I can have withheld.  Worst case I go and get a new eye exam and buy a new pair of glasses or some boxes of contact lenses and I'm right back above the mark and completely paid for (though if I do that I'll tend to have used up more than I should and would have otherwise so I wind up with some un-reimbursed expenses that could have been delayed if the funds had been dispursed like I originally estimated and expected).

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Reply #3 from JoeUser Forums Top

Perhaps I misunderstood a bit.  Our plan had a credit card we could use to charge against our savings.  And yes, that was a real PITA!  So I quit using it. So much easier just to pay out of pocket and then get reimbursed.

Reply #4 from JoeUser Forums Top

Perhaps I misunderstood a bit. Our plan had a credit card we could use to charge against our savings. And yes, that was a real PITA! So I quit using it. So much easier just to pay out of pocket and then get reimbursed.

I think I'm quickly reaching the conclusion that you did.  I can just pay up front and then get reimbursed but then I have to fax in copies of receipts and such and wait for the funds to be direct deposited.  I'd rather not be lending my Flex Spending account my own money since I've already given them, or will give them throughout the year, a contribution from my wages and salary that was supposed to take care of that.  If I have plenty of $$ in the bank, it's not a big deal, but then again I feel silly paying up front just because the company are such jerks and idiots about how they demand supporting justification for payments made using the card.

I do think I've figured it out a bit better, and really it comes down to (likely) NEVER sending them a copy of an EOB unless they demand that for proof.  If I can just send them an itemized receipt, I'll do that instead and then there's likely less argument over  the issue.  Still, I'll be glad when my kids have their own jobs and I no longer have to budget their needs into things as I know for me that setting aside enough to cover my glasses/contact lenses and some regular dental work should cover me.

Reply #5 from JoeUser Forums Top

I agree PayFlex are steaming, smelly piles of crap, and wonder why they exist at all.  Wouldn't BCBS want more of the money I pay instead of paying some of it to these folks?  If I could only pay these folks electronically, most of their worries about premium payments would be over.  But their "wonderous" system has been apparently thoroughly broken...since AT LEAST June.  Seems their system is just a ruse.  You put in the information asked and it nearly always responds that registration was successful, and to expect to receive a confirmation email with some sort of (email) validation code within 10 minutes.  Like I (sort of) said, I've been waiting for this validation email--SINCE JUNE.  I try every few days, and am tempted to take this as a challenge in cURL programming, run from a cron job every half hour or so.  Maybe their system only works at 3:00 in the morning for 2 minutes or something.  Otherwise I see no possibility of it having worked, ever, in my lifetime.

edit: OK, I guess it's their way of stimulating the economy.  They've spent plenty in postage, paper, ink/toner, etc. to send me notices about how much I owe, that I'm about to be/am cancelled (due to insufficient premiums paid, despite writing out a check for exactly the amount they told me over the phone--which apparently they couldn't even tell me the correct amount).