PayFlex Systems USA review: Refusal to pay after submitting appropreciate docs 75

There are a variety of complaints here. Some valid and some not in my opinion. It is not always PAYFLEX, but sometimes it is. The difference is that when the individual is correct, they are still punished. My experience is this: Payflex does not always communicate well. The reasons for denial is usually generic with a code that customers cannot determine. Therefore, it is difficult to determine what is really required to resolve the issue. This is compounded by the fact that the employees are not all knowledgeable (poor sporadic training). For example: I have a recurring maintenance drug charge that is allowed. In the last year it was submitted many times from the same company and same charge. It has been denied about 50% of the time. Part of the problem was found to be my ignorance of expectations not clearly identified. The expense can fit two of the PAYFLEX choices (prescription, maintenance). Initially, I selected prescription and was denied. My appeals were also denied. It typically takes several communications with representatives to find one that knows how to change the expense to maintenance and resubmit successfully. I typically have to talk to 3 representatives before the issue is resolved. I have had to talk to as many as 5 representatives. About 20% of the time, the representatives are not knowledgeable of plan requirements, other times, the changes just don't happen (reason unknown). My conclusion is that poor training of staff is contributing to everyone's frustration. Poor training cannot be attributed to the client company. It is really great when you get one of the knowledgeable employees. Everything is corrected.

This company is by far the WORST company I have ever dealt with. Like many other complaints, it is a constant battle to use MY money for legit expenses. Most recently was over a visit to the emergency room. The bill even stated it was from a hospital ER. Seriously? Do they think I went there for drinks and a party? I too have made more calls to them than I care to remember. Their customer service is beyond bad. When discussing my issues with them, I even had one rep tell me it wasn't my money, but my husband's. Unbelievable. My name is also on the account. Don't know what third world country they found this rep in, but here in America, most woman don't walk three feet behind their husbands and all (including money) is equal. Beyond unprofessional on the part of Payflex. This year we did not sign up again. Honestly it isn't worth the aggravation. I strongly discourage everyone to avoid this company at all costs...your blood pressure will thank you.

I would also like to add one more thing that I have not seen addressed. Changing an address with this company has proven to be impossible. I have gone through all their hoops as in contacting our HR department. Address changes completed on the HR end, however, Payflex still wont' change it for their records. I had so hoped to never have the need to deal with this company ever again as we did not sign up to use them for the new year. Sigh, 4 months later they are attempting to deny a hospital charge made during the latter part of the previous year and are yet again demanding more paperwork from me. If I had to describe this company using only one word, the word would be NIGHTMARE!

Payflex is a piece of garbage company. I have worked in benefits in the HR side for 15 years and have never experienced such terrible service. Payflex goes out of their way to deny claim and with hold the employees hard earned money. Dealing with their claim service in which they will deny claims for arbitrary reasons such as it has the name of the dental group but not the name of the provider. Or if you pay for your service because your insurance doesn't cover the crown they will just keep denying your claim even after calling every month and them saying they need itemize documentation. When you finally get a hold of a supervisor they finally tell you that you need and EOB and when you explain that you don't have one because insurance didn't pay for anything they tell you that you need to get proof that insurance didn't pay for your dental work. How are you going to get proof that something never happened. Sadly my company is a mammoth company and while we have changed our FSA providers for the group that I manage I sadly am stuck with this poor excuse for a TPA that denies things that no other TPA has ever had problems approving. This company makes it so that dealing with them isn't worth any tax incentives. I will be keeping my hard earned money and my sanity come next plan year.

I suspect that Ronald who posted 3 times in favor of Payflex works in their marketing department. Save the hassle don't hire Payflex if you have another option and if your company sticks you with Payflex don't bother unless it's for Dependant care. The rest is just a joke.

I became a Pay Flex Systems customer (no choice in the matter) in Jan 2016 and I have to say it is not a pleasant experience. Getting HRA funds for medical expenditures is a frustrating experience to say the least. I have read many many complaints regarding this company and seriously wonder how they stay in business. I just got off the phone with these folks regarding a simple month old unpaid prescription claim and was told to call back in five days and see if the claims review department had resolved the issue. If a claim is denied, a specific reason for the denial is not forthcoming. I cannot adequately convey my dissatisfaction with Pay Flex and can only say that if I had a choice, I would use some other company for these services.
It is my fervent hope that someone will mount a class action lawsuit and get their attention.

I submitted the receiots from the dentist office many many many times forvtgem to tell that i overpaid the dentist. Question what does that have to do with me? Your job is to validate the charge and make sure it matches. Now if the guudelines have changed where they are now the insurance company and the account manager of the dentist office has nothing to do with. They need to call the drntist iffice and tell tgem their prices are too high end tell Aenta too stop beong so cheap. I sent what i was charged. I've usrd the flex for many many years this foolish here is the worst and the customer service isnt any better telling me i overpaid and its my money!

I am trying to get a password changed on their website. this task seems next too impossible. This whole debit card idea seems like a total waste of time. I thought the entire point was to eliminate the need to submit receipts, this would address. What's the point of going through the hassle of using the debit card, if you are going to have to submit receipts separately. I'll just submit separately, once I can get my password reset. Ugggh. Much happier when healthhub was their own site.

I agree with all the negative comments with regards to payflex. They HIDE behind the term of "following IRS guidelines"..
I have wasted more hours having to justify using the card at Doctors and Dentists that I too agree someone needs to look into a class action suit. My new favorite is that they have shut my payflex card down for a 2013 dental bill they say I did not send the correct information on. I had a root canal. I am now told that to get the card reactivated I need to send them the 370.00 amount they have questioned. I asked well where does the money go now since it came from my paycheck, the answer is I don't gt the money they do and it is claimed as administration expenses! Payflex, A.K.A AETNA are failing as administrtors. I am sure they are making a lot of money from many many people!

This company is worse than any government agency that I have had to deal with, and we all know how bad and inefficient the government can be. Totally pathetic, will never have another flex spending account with them again.

We are considering dropping out of using PayFlex completely next year. It's not worth it. We're a very healthy family, and we're always in a scramble to use the money at the end of the year. That being said... it seems they have an issue with going to the dentist! EVERY. SINGLE. TIME.Whenever one of us in my family of four have to get any procedure done besides a cleaning (which is covered by insurance), it's a HEADACHE to get full payment approved. It used to be OK to just submit the dental office receipt; this year, they claim that's insufficient and want the dental insurance documentation as well. EVERY SINGLE TIME we do that, they then will nickel and dime us and say the dentist's office is charging us $___ too much out of pocket so they will deny that part of the claim. It's typically somewhere around $20-25... and for that, they will shut down our payment card so we can't access the funds at all until we submit another claim out of pocket against that $$.

Last I checked, they were the account managers... their job is to hold OUR money that is eligible for medical expenses. it's NOT their job to tell us that, in their OPINION, they believe the dentist's office charged us $20 or $25 too much after insurance coverage. Are you kidding me? I can't tell you how many hours my husband and I have spent calling them and submitting paperwork, just to have our account suspended pending us "paying back" the $20-25. We've been going to my dentist for 19 years... and he more than deserves what he charges (which IS very reasonable). They tell us it's to have a "bargaining point" with the dentist; WRONG. I'm NOT going to nickel and dime my dentist for being an awesome dentist! It just puts the onus on us to pay OURSELVES back OUR money that THEY'RE holding.

It seems the dentist's office is the only issue we've had. Everything else is fine, goes right through. Unfortunately, most of our medical expenses - since we ARE a very healthy family - are the dentist. As I said, we're pretty sure after this year we won't be using PayFlex again... instead, we'll pull that money out and put it in a savings account. At least then we won't have to scramble to spend the money at the end of the year or lose it. Enough is enough.

I want to echo all the other negative comments. Payflex has a terrible system and is completely inconsistent when giving out information. I'll call in 3 times for a single issue and receive a different story each time with a different request for different documentation. Eventually, I'll get someone that knows what they are doing, tell me clearly what they need or simply read the actual receipt I uploaded and fix the issue. However, it's usually after

Their paid social media shills on here defending them are EXACTLY the kind of attitude you get when you call in. They tell you that you are wrong before they even listen to your explanation, then they tell you it's really your problem and not theirs, then they give you a pile of misinformation and move on to their next call.

I submitted documentation for a $91 payment to an oral surgeon. I also submitted the EOB. I sent it via fax, email, and upload. After 6 submissions, I finally sent the documentation CERTIFIED MAIL with return receipt requested. They held $1200 in funds for the $91 payment. I even submitted offsetting expenses. That was for 2015 benefit year. I am now going through the same issue. I have submitted documentation for eye surgery three times already. It seems they pull this crap at the end of the tax year every year in an attempt to keep the money paid in throughout the year. I am going to file complaints with my HR Department, as well as any governing agencies I can get ahold of. If there is a class action, I would love to be included...

For years my company used Tasc by visa, this year Payflex by Mastercard. They waited until the last month of the year and now request verification of every transaction, all the co-pays, doctors visits, etc. Never had this once with Visa.
I asked them why they waited until the end of the year and not the first transaction, they don't know. It is now up to me to chase all of these down, visit the offices, (glasses, sleep data, etc.) I am so frustrated, I did payflex on payroll deduction and thought I was making my life easyer. Master Card are not Visa, that's for sure!

We refuse to ever use our Payflex card again. Every time we use it they will place a hold on it until we send in information they request. After jumping through their hoops they always, and I mean always, lose the information we sent in. We have decided to file the EOB's ourselves and have the money direct deposited into our bank account. This works alright, but they always lose the information the first few times. So, I suggest sending it return receipt requested the first time to avoid a headache, however, I will upload them a couple of times before I send by mail because sometimes we get lucky.
We have been doing it this way for the past 3 years and it is a lot less stressful than showing up for an appointment just to find out your card is inactive! Good luck everyone...This place is a nightmare!

Is there any class action litigation against Pay flex? If not, how do we initiate? This company is stealing people's money.

I am tired of the constant run around to be reimbursed with my own friggin money. I get there is a lot in place to prevent tax evasion and all that but the hassle it has become with lost time and lost money. Don't use PayFlex. I refuse to after this year. It is not worth it. Just save the money in a bank account.

For last 3 weeks there system is not allowing me to login and each time when i call i get request to try in few days and no ETA date.
Very Poor management of IT and customer service

I believe Payflex FSA to be unethical in several ways. They challenge every charge not matter what documentation I provide including Explanation of Benefits from the insurance company, detailed 'walk out' bills at provider offices, and reverse approvals on charges after the calendar has run out putting them in the position of retaining my funds and leaving me in debt.

At the same time, the use threatening language on a first enquiry into a charge. The amount of detail they request including whether a charge will be added to my insurance company deductible or not, is unnerving. The insurance company finds Payflex's demands for additional detail to be beyond IRS requirements and unorthodox.

If I could break the account mid-benefit year, I would. It would be more efficient and cheaper to pay with post tax dollars.

I too need to file a complaint against PayFlex because of the same exact reason. I submitted all documents before the deadline (including LOMN, receipts and claims forms) and they refuse to reimburse me for my expenses.

I too am appalled at the ability of a company to deny claims with appropriate documentation to then give participants in “forfeiting” their hard earned money and claim they are backed by the IRS to keep said funds for administrative costs. This is a scam and unethical as there is no way to stop the payments when you are outside of open enrollment and no way to remove funds with the option to be taxed so that they are not lost. I will gladly join a class action if one exists!

Payflex has stopped allowing Quicken to connect and download transactions.

It worked fine for years, then suddenly stopped working on or about Jan. 9, 2023. It has not updated my accounts since.

Payflex...Horrible company to deal with ! nothing good.

I received a letter from Payflex asking for documentation my social security card and drivers license. When I called them they wouldn’t verify me and I ended up providing my last 4 digits of my social security number and then they still couldn’t verify me even though they sent me a letter. Are these people scammers ?

Payflex has horrible service. No sign of professionalism in the way of handling issues.

It has been a month trying to solve the issues, but they provide no sign of professionalism to assist.

Horrible and worst customer service ever.

I have requested an FSA card to access my available funds three times and still have not received a card. Every time I request another card the customer service representative tells me they have sent the card to the address on file.