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Auto substantiation is electronically verifying that benefit account funds were used for eligible expenses according to IRS regulations. The IRS requires that all benefits card transactions be substantiated – either electronically or manually. A high auto-substantiation rate means that participants won't need to submit as many paper receipts. Fewer receipt requests translate into increased convenience for the participant and reduced operating costs for the TPA or health plan.
Auto substantiation isn't easy. We just make it look that way. Evolution Benefits works for our clients to achieve among the highest auto-substantiation rates of all benefits cards. We offer all the IRS-approved auto-substantiation methods and have the expertise to use them effectively. (In fact, we invented most of them!)
First, our system disallows use at inappropriate locations (e.g., gas stations). Then, it applies the auto-substantiation methods selected by the TPA/employer. Through long-term contracts with the nation’s largest pharmacy benefit
Click chart for details on the substantiation options available
for each type of transaction.
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managers (PBMs), we receive data that allows us to offer you a choice that no one else can – 100% real-time substantiation for prescriptions! We also receive data from more health plans and carriers than any other card vendor to electronically substantiate outside the pharmacy.
Result: Around 8 out of 10 transactions for employers using pharmacy benefit manager (PBM) data don’t need receipt follow-up. |
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