Jane and HSA/FSA: What Clinics Can Offer
Whether an HSA card works is a payment category question, not a Jane question. What clinics on Jane can offer, and how to set it up in 30 minutes.
7 minute read
Short answer
Unlike most practice software, Jane gives you a real answer here. Jane's own documentation says that when you sign up for their payments product they set your account up under a medical category, and that this means you're set to accept HSA and FSA cards. So for most clinics on Jane, the card does go through.
That's worth knowing, and it's also worth knowing exactly what it settles. Jane is straight about the limits: they say they can't guarantee an HSA card will be approved, and that a client's card issuer can decline for any number of reasons. More importantly, an approval is the card network agreeing your business category looks medical. It isn't the client's plan agreeing the service was eligible, and the plan can come back to your client for documentation on that charge months later.
That's the gap Burst fills, and it's a gap you have whether or not the card clears. A licensed clinician writes the letter of medical necessity naming the condition, and Burst files the reimbursement claim. $100 a month with no contract, plus a $20 one-time letter fee, live in 30 minutes, and nothing about Jane changes.
To offer it this week, start at getburst.com/self-serve.
(Reading this as a client, not a clinic on Jane? You can get a letter for your own care directly from Burst.)
What the card approval actually settles
Two different questions get collapsed into one whenever a card goes through.
The first is whether the payment can run. That's about how your business is categorized, and Jane handles it for you by setting your payments account up under a medical category. Jane also says plainly that they can't guarantee approval, and that a client's card issuer can decline over transaction size, available funds, preset limits, or the card simply not being valid at a clinic like yours.
The second is whether the client's plan agrees the service was eligible. The card network never asked that question. A swipe records that a charge happened at a medically categorized business, and nothing about why the care was medical. If the plan reviews that charge later, your client is the one who has to answer, and the receipt on its own usually doesn't.
So the card is a payment mechanism. The letter is documentation. They aren't competing, and a clinic that has both is in a much stronger position than one with either alone.
What Jane does and doesn't do here
Question | Answer |
|---|---|
Can my clinic take an HSA or FSA card? | Usually. Jane sets new payments accounts up under a medical category, which is what the card networks look at |
Is approval guaranteed? | No. Jane says so directly; the client's card issuer decides each transaction |
Does Jane document why the care was medical? | No. That isn't what a payment system does |
Does Jane file a reimbursement claim for the client? | No |
Does Jane have an HSA/FSA integration with a letter provider? | No |
What happens if the plan asks my client for paperwork later? | Your client answers it alone, unless someone wrote a letter and filed the claim |
None of that is a criticism of Jane. A practice management system is not supposed to adjudicate medical necessity. It just means the documentation side is still yours to solve.
The options for a clinic on Jane, side by side
Truemed | Flex | Burst | |
|---|---|---|---|
What it is | Card-rail HSA/FSA checkout, LMNs, partner marketplace | Card-rail HSA/FSA checkout, LMNs, partner marketplace | LMN and reimbursement platform, no checkout involvement |
Who files the reimbursement claim | Nobody; the customer is left to file | Nobody; the customer is left to file | Burst files it for the member |
Getting live | Sales call, then checkout integration, typically weeks | Sales call, then checkout integration, typically weeks | Self-serve, live in 30 minutes, no integration |
What it costs you | Not public; typically a rev share | Not public; typically a rev share | $100 a month, month to month, no contract |
Customer letter fee | Not published | Not published | $20 one-time, paid by the customer or by you |
If no letter is issued, or the claim is denied | No published guarantee | No published guarantee | The $20 is refunded automatically |
Business types accepted | Partner application | Partner application | Any clinic on Jane, no application |
Contract | Set in their sales process | Set in their sales process | Month to month |
Taking the card and offering reimbursement aren't alternatives. Plenty of clinics do both: the card handles the payment, the letter and the filed claim handle the documentation.
Why Burst is the best HSA/FSA option for a clinic on Jane
Burst files the claim. A licensed clinician reviews each client's case and issues the letter when it's appropriate, and Burst submits the claim to the client's FSA, HSA, or HRA administrator. The client does no paperwork. With Truemed and Flex, the client does all of it.
The client's fee is refunded if it doesn't go through. No letter, or a denied claim, and the $20 comes back automatically. Neither Truemed nor Flex advertises a comparable guarantee. Recommending it never costs a client anything, which is what lets you say it out loud.
The price is published. $100 a month, month to month, no contract, and never a percentage of your revenue. You know the cost before you talk to anyone.
It needs nothing from Jane. No integration, no app, no partner agreement, and nothing that breaks when Jane ships an update. Your charting, scheduling, billing and payments keep doing exactly what they do now.
See how it works or go live now.
What does it look like for a client?
A client books and pays through Jane the way they always have, then follows your Burst link to a two-minute intake about the condition they're managing. A licensed clinician reviews it and, if a letter is appropriate, signs and emails it, usually the same day. Their appointments and any package keep running through Jane unchanged. Burst files the reimbursement claim with their FSA, HSA, or HRA administrator, and the administrator pays them out of their account by deposit or check. No letter, or a denied claim, and the $20 fee refunds automatically.
One timing rule. The letter has to be dated on or before the appointment or package it covers, so raise it at the first visit, because the letter has to predate what it covers. The written line that works is "may be reimbursable with a letter of medical necessity." It's accurate, because the client's plan decides each claim, and it still sells.
Why this matters more for a Jane clinic than most
Jane is used heavily by physiotherapy, massage, chiropractic and multidisciplinary clinics. That's the part of this whole category where clients are most likely to be managing something a clinician will name in writing, and where the plan is most likely to take a second look at a charge.
It also means the demand is already sitting in your client list. You aren't persuading anyone that their care is medical. You're giving the people who already know it a way to get paid back for it.
How to offer this alongside Jane
Sign up at getburst.com/self-serve. About 30 minutes, and nobody from Jane is involved.
Decide who pays the $20 one-time letter fee: clients, or you as part of a package.
Put your Burst link in the appointment confirmation, on your intake form, in your package emails, and on a card at the desk.
Keep using Jane exactly as you do now. Clients enroll, get their letters, and Burst files their claims.
If your clients are already tapping HSA cards at your desk, this is the piece that stands behind those charges when a plan asks.
Frequently asked questions
Does Jane support HSA and FSA cards?
Yes, for most clinics. Jane's own documentation says they set new Jane Payments accounts up under a medical category, and that this means you're set to accept HSA and FSA cards. They also say approval isn't guaranteed, because the client's card issuer decides each transaction.
My client's HSA card went through. Doesn't that settle it?
No. An approval means the card network agreed your business category looks medical. It isn't the client's plan agreeing the service was eligible, and the plan can ask your client for documentation on that charge later. The letter is what answers that.
What is the best HSA/FSA option for a clinic on Jane?
Burst, alongside whatever you already do at the till. It needs nothing from Jane, it's live in 30 minutes, it costs $100 a month flat with no revenue share, and Burst files the client's reimbursement claim. Truemed and Flex both require a sales call and a checkout integration on their card rails, don't publish their terms, and leave the client to file alone.
Do I have to stop taking the card?
No. Plenty of clinics do both. The card handles the payment and the letter handles the documentation behind it.
Do I have to change anything in Jane?
No. Burst doesn't connect to Jane. Your charting, scheduling, billing and payments stay exactly as they are.
Can a client be reimbursed for visits they already paid for?
No. The letter has to be dated on or before what it covers, so raise it at the first visit.
Is the letter a guarantee the client gets paid back?
No. The client's plan administrator decides the claim under its own rules. Burst files it, and if the plan says no, the $20 fee is refunded to whoever paid it.
More on this: Best HSA/FSA Option for Massage Therapists, Does Your Gym or Studio Software Support HSA/FSA?, Best HSA/FSA Option for Recovery and Stretch Studios, and Truemed Alternatives for Your Store, Gym, or Spa.
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