My employer offers up to $500 in healthcare reimbursement per year to cover out of pocket costs. This is managed by my health insurance company and is paid directly to the provider. A major problem with trying to explain this is that even though it's called a Health Reimbursement Arrangement, the money is being paid directly to the provider instead of being reimbursed to me.
For example, if my out of pocket cost is $175, and there's $56 left in my Health Reimbursement Arrangement, then my insurance will sent $56 to the healthcare provider to cover part of the out of pocket cost. In this context, the insurance company is simply acting as an agent to pay the money from my employer to the healthcare provider. However sometimes the healthcare provider will not credit the bill for the $56 and will have no idea what I'm talking about when I call them. This is also the case when there's enough money in the HRA to cover the full bill, but they send me the bill anyway and don't understand what an HRA is.
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