BPA

1-800-867-5615

At this time, this payer is not providing real-time adjudication, so all claim requests will come back with a “claim pending” response. Therefore, claim submission is only available with the option “payable to” the patient. Please ensure you collect the full treatment amount from your clients covered by this insurer.

A response following a claim acknowledgement is usually processed within a week. Predeterminations and rejected claims are mailed to providers daily, and cheques along with explanation of benefit statements for payable claims are mailed on the 1^st and 15^th of each month.

At this time, this payer is not providing real-time adjudication, so all predetermination requests will come back with a “claim pending” response.

Payments for select vision care services that are submitted from the Provider Portal or the eClaims integrated Practice Management software can be assigned to vision care providers (opticians and optometrists). Payments for all other types of services, as well as payments for claims submitted from the mobile app, must be assigned to insured members.

For vision claims submitted via the Provider Portal or eClaims integrated Practice Management software, if the payment is assigned to the provider, then the client does not pay. In all other cases, payment must be collected from the client for services rendered. The insurer will reimburse its members directly in accordance with the method of payment applicable to their plan.

No.

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

• Acupuncturists (Only allowed if the acupuncturist is registered with the College of Traditional Chinese Medicine)

• Athletic therapists

• Chiropodists

• Chiropractors

• Dietitians

• Massage therapists

• Naturopathic doctors

• Occupational therapists

• Opticians

• Optometrists

• Osteopaths

• Physiotherapists

• Podiatrists

• Psychologists

• Psychotherapists

• Social workers

• Speech-language pathologists