Why Wasn't My Claim Fully Reimbursed?

Your claim has been reimbursed but you didn't receive the full amount that you were expecting? See below for some information that should help you understand what is going on with your claim. 

If you log into your MyOlympia account > Claim Activity you can see your claims history. Click on the specific claim and you will be able to see to what was paid out. If the claim wasn't full reimbursed, you will see a rejection code. Below are some of the most common reasons a claim isn't fully paid out. 

Code #1: Benefit allotment for the date of service has been exhausted. This means that you don't have any balance left for the date of service for your claim. Your employer gives you a specific limit for each plan year, once that limit has been exhausted, your balance is zero dollars. 

Code #5: Expense incurred prior to effective date on plan. Olympia will only reimburse claims that have a service date after you have been enrolled onto the benefits plan. Receipts dated prior to your effective date will be rejected. 

Code #9: Item has been reimbursed on a previous claim. If you see this code, it means that you have already been reimbursed for the receipt on a previous claim. Take a look at your claims history to find out when it was reimbursed. 

Code #13: Ineligible - your plan does not cover this type of expense. Olympia follows the Income Tax Act for claim eligibility. If you submit an item that is not covered (for example, Reiki treatments) it will be rejected. You can view a full list of eligible expenses with your MyOlympia account > Manage > Eligible Expenses. 

If you see a rejection code that is not listed above, you can view the full list of codes in your MyOlympia account. Login and click on Manage, at the bottom of the page you will see a link titled "Explanation Codes". There you will see our exhaustive list of codes. 

If the reason for a rejection is fixable, such as requiring a proof of payment, a new claim can be processed in the same manner that you submitted the original claim. You can also send us the required documents if the claim has not been paid out yet. In the event that the claim has been rejected as it does not meet the eligible claiming criteria, that item cannot be resubmitted.