MDM Insurance Services
How do I contact the insurance company?
(519) 837-1531 or (800) 838-1531, Monday to Friday, 8:00 a.m. - 8:00 p.m. ET
What are the hours of adjudication?
6 am to 12:00 am (ET)
Once an Acknowledgement is generated, what is the time frame for receiving a response?
The claims are processed in real-time and the answer will be immediate.
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?
Payments will be handled via Electronic Fund Transfer (EFT) 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?
MDM issues both cheque and EFT payments each business day. EFT payments are processed within 1-2 business days depending on the financial institution.
Payment statements will be available on the TELUS Health portal.
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?
For the Policy, please enter the Group Policy # from the MDM benefit card.
For the Member, please enter the Subscriber/Client ID # from the MDM benefit 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)?
No. The second claim will reject as a duplicate.
What expense types can be submitted electronically, and which specialized healthcare provider roles does the system support?
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Acupuncturists
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Chiropodists
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Chiropractors
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Dietitians
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Guidance counsellors
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Laboratory clinics
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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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Physiotherapists
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Physiotherapy Technologists (all provinces except Quebec)
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Podiatrists
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Speech-language Pathologists
When a claim generates an acknowledgement response (pended claim), how long does it take the insurer to process that pended claim?
Currently, MDM Insurance Services Inc does not pend claims.