HSA / FSA Reimbursement Guide
Most plans accept digital health tools when you include a receipt and a Letter of Medical Necessity (LMN). Follow these steps and keep copies for your records.
1Save your receipt
Use your ThrivingFam subscription receipt or App Store / Play Store email.
2Attach an LMN
Have your clinician sign the letter below. Include child name, diagnosis, and how the app is used for care.
3Submit to your HSA/FSA
Upload the signed LMN + receipt. Keep PDFs for future audits.
Letter of Medical Necessity Template
Copy, customize, and have your clinician sign. Then save as PDF (File → Print → Save as PDF).
Date: __________
To Whom It May Concern,
I am the treating clinician for __________________________ (patient name), diagnosed with __________________________. The patient requires structured tracking of medications, behaviors, sleep, and related health data to inform clinical decision-making and monitor treatment effectiveness.
I am prescribing ThrivingFam, a HIPAA-compliant digital health app, to:
- Track medications, side effects, and behaviors in real time
- Document sleep, routines, and triggers to optimize treatment
- Share accurate logs for visits and care-team coordination
- Generate reports that support ongoing medical management
This tool is medically necessary to improve adherence, monitor response, and reduce adverse events. I recommend coverage under the patient’s HSA/FSA plan.
Clinician Name & Credentials: __________________________
License / NPI: __________________________
Signature: __________________________
Date: __________________________
Tips to speed approval
- Include child name, diagnosis code (if available), and clinician signature.
- Submit the LMN + receipt together. Many portals allow PDF uploads.
- Keep your own PDF copies in case of audit.
- Mention that ThrivingFam is HIPAA-compliant and used for medication/behavior monitoring.