TELUS AdjudiCare

TELUS AdjudiCare is an aggregated submission option that is used by many different small insurers and third party payers (TPPs) who cover small groups of plan members. They use a solution called AdjudiCare to process drug, dental and extended healthcare claims. They are now connected to eClaims as one aggregated submission option to help ease your experience when selecting an insurer in the claim submission process. Since TELUS AdjudiCare is aggregated and each payer under this name has its own processes, your experience when direct billing to this group will vary, depending on the payer receiving the claim/predetermination request.

TELUS AdjudiCare is aggregated and used by many different small insurers. Please contact your insurer directly.

Claims can be submitted 24/7.

TELUS AdjudiCare is aggregated and used by many different small insurers. As such, the response time varies by each insurer/payer under TELUS AdjudiCare. The processing time varies from one to two weeks, plus transit time to mail the statements.

Yes.

Since TELUS AdjudiCare is aggregated and used by many different small insurers; the response time for a predetermination varies by each insurer.

TELUS AdjudiCare is aggregated and used by many different small insurers. As such, the answer to this question varies according to each insurer/payer under TELUS AdjudiCare. If the payer and the benefit plan allow for payment to the provider, then the claim will be accepted. If payment to the provider is not allowed, then the claim submission will be rejected and the explanation of benefits returned to you. eClaims will indicate this as the rejection reason.

TELUS AdjudiCare is aggregated and used by many different small insurers. As such, the answer to this question varies by each insurer/payer under TELUS AdjudiCare.

Payment is sent within 3 and 10 business days, by either cheque or EFT (direct deposit).

At this time, payment statements are sent by mail. In 2022, electronic payment statements will be available.

TELUS AdjudiCare is aggregated and used by many different small insurers. As a result, this varies by each insurer under TELUS AdjudiCare. The cards generally follow the format below and use these titles for the ID numbers shown. Most of these cards will include reference to “TELUS AdjudiCare” (as shown in the sample below).

Only one treatment per day for the same procedure code is eligible.

Expenses for the following specialized healthcare providers are supported:

• Acupuncturists

• Chiropodists

• Chiropractors

• Counsellors

• Dietitians

• Massage therapists

• Naturopathic doctors

• Occupational therapists

• Opticians

• Optometrists

• Osteopaths

• Physiotherapists

• Physiotherapy technologists

• Podiatrists

• Psychologists

• Psychotherapists

• Social workers

• Speech therapists