GroupHEALTH
How do I contact the insurance company?
1-833-344-6944, Monday to Thursday 7:30 a.m. to 9:00 p.m. EST; Friday 7:30 a.m. to 7:00 p.m. EST
What are the hours of adjudication?
Claims are adjudicated 24 hours a day, 7 days a week, excluding occasional maintenance periods.
Once an Acknowledgement is generated, what is the time frame for receiving a response?
Acknowledgements will be processed, and members sent a response, within three to five business days.
Will the insurer accept a predetermination request that is submitted electronically?
Yes, predetermination requests are accepted.
Payment: How will payment be handled for claims submitted using eClaims? Would it be possible to set up a direct deposit option for payments?
Payments can be made by direct deposit or cheque. If you have signed up for direct deposit through TELUS Health, you will be paid by direct deposit and a notification will be emailed to you. Direct deposit and cheque payments are made every business day.
Coordination of benefits: Is coordination of benefits possible in cases where the patient has both primary and secondary coverage with the same insurer?
No, this option is not currently available.
Can claims for the same service be submitted twice in the same day (e.g. for the same service on two different body parts, or for the same service provided in the morning and in the evening of the same day)?
In this case, the second of these claims will be considered a duplicate and will be declined. Your patient should submit it manually through their Health plan.
What expense types can be submitted electronically, and which specialized healthcare provider roles does the system support?
All eClaims-eligible healthcare provider disciplines are supported, except dietitians, speech language pathologists, occupational therapists, and social workers.