Maximum Benefit
How do I contact the insurance company?
1-800-893-7587, Monday to Friday 7:30 a.m. to 6:00 p.m. CST
What are the hours of adjudication?
Claims are adjudicated 24 hours a day, 7 days a week, with a short maintenance window at 11pm EST.
Once an Acknowledgement is generated, what is the time frame for receiving a response?
Acknowledgements are treated the office and returned to providers within two to four business days.
Does the insurer accept a predetermination request submitted electronically?
Electronic submissions of predetermination requests are accepted. In most cases, the predetermination will result in an immediate response of eligible amounts. In rare cases, the predetermination will be held for review. In those cases, the completed predetermination will be returned to the provider in hard copy form within 2 to 4 business days.
Is payment to provider (benefit assignment) possible?
Payments to the provider are supported. The insured will be notified of any claims processed using their identification numbers.
Payment: How will payment be handled for claims submitted using eClaims? Would it be possible to set up a direct deposit option for payments?
Provider payments can be made by direct deposit or by printed 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. All other provider payments will be made by printed cheque. All payments are processed every working day for claims processed the day before. Claims held for review or audit are typically released for payment within two business days.
Coordination of benefits: Is coordination of benefits possible in cases where the patient has both primary and secondary coverage with the same insurer?
Coordination of Benefits with the same provider is not supported at this time.
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)?
Yes, you can submit for the same service twice in one day but the second claim will be held for review.
What expense types can be submitted electronically, and which specialized healthcare provider roles does the system support?
Expenses for the following specialized healthcare providers are supported:
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Acupuncturists
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Chiropractors
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Chiropodists
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Dietitians
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Massage therapists
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Naturopathic doctors
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Occupational therapists
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Opticians
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Optometrists
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Osteopaths
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Physiotherapy technologists
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Physiotherapists
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Podiatrists
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Psychologists
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Psychotherapists
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Speech language pathologists
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Social workers