Canadian Benefit Providers
How do I contact the insurance company?
855.944.9166
What are the hours of adjudication?
8:00 EST – 20:00 EST
Once an Acknowledgement is generated, what is the time frame for receiving a response?
All Claims are processed in real time. The adjudication result is presented at time of claim submission.
Payment: How will payment be handled for claims submitted using eClaims?
Electronic funds transfer or cheque.
What is the frequency of payment?
If direct deposit can be set up, is a payment statement issued?
How is the statement delivered?
Once a week.
Payment statement is via the TELUS Payment statement.
Coordination of benefits: Is coordination of benefits possible in cases where the patient has both primary and secondary coverage with the same insurer?
Yes.
What do I enter in the Policy / Group and Member ID / Certificate fields? Where do I find this information for my patient?
Plan Number from the Card is the Policy Number. Each eligible patient has their unique ID listed on the card.
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, if distinct procedure codes are used.
What expense types can be submitted electronically, and which specialized healthcare provider roles does the system support?
Expenses can be electronically submitted for all healthcare roles that TELUS Health currently supports.
When a claim generates an acknowledgement response (pended claim), how long does it take the insurer to process that pended claim?
Claims will not be pended.
Providers can only submit a claim with dates of service up to 31 days prior to the day it is submitted. Is there a further insurer restriction on the allowed dates of service? If so, what is that restriction?
Claims must be for services provided. Future service dates or gift card purchases are restricted.