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Benefit Sub Category Patient Name Submitted Paid Status Service Date Submitted Date
Claim Types
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Dental
Drug
Wellness
HSA
Health
Chiropractor
Physiotherapy
Massage Therapy
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Patient
HSA balance
Current Year
Allotted amount Paid Balance
Previous Year
Allotted amount Paid Balance
Balance is as of Midnight (EST). Claims processed today will be reflected on the next business day.
Note

Claim eligibility for payment is determined at the time your claim is processed. The amount payable is based on and not limited to your plan design, deductibles, percentage paid by your benefits, maximums, coordination of benefits, etc. For more details, refer to your benefit booklet or contact our Customer Response Centre.

HSA balance Wellness balance
Benefit
Balance is as of Midnight (EST). Claims processed today will be reflected on the next business day.
Note

Claim eligibility for payment is determined at the time your claim is processed. The amount payable is based on and not limited to your plan design, deductibles, percentage paid by your benefits, maximums, coordination of benefits, etc. For more details, refer to your benefit booklet or contact our Customer Response Centre.

Patient
Specialist Type
Procedure Code
Category Lookup
Dental Coverage Information
Procedure Description Eligible Deductible eClaim Type Eligible Amount
Eligible Amount
Tier Info
Copay Per Claim Visit To a Maximum
Maximum Accumulated Remaining
Frequency Accumulated Remaining
Note

Claim eligibility for payment is determined at the time your claim is processed. The amount payable is based on and not limited to your plan design, deductibles, percentage paid by your benefits, maximums, coordination of benefits, etc. For more details, refer to your benefit booklet or contact our Customer Response Centre.

Patient
Drug Detail Information
No Results Found
DIN Not Found
Drug Coverage Information
Eligible
DIN Drug Name Deductible eClaim Type Co-Insurance Specialty Support Mail Order
ValueHealth Effective Date Terminated Date
Special Requirement
Maximum Accumulated Remaining
Quantity Accumulated Remaining
Note

Claim eligibility for payment is determined at the time your claim is processed. The amount payable is based on and not limited to your plan design, deductibles, percentage paid by your benefits, maximums, coordination of benefits, etc. For more details, refer to your benefit booklet or contact our Customer Response Centre.

Patient
Category
Category Lookup
Health Coverage Information
Category Sub Category Eligible Referral Required eClaim Type Eligible Amount
Eligible Amount
Tier Info
Copay Per Claim Visit To a Maximum
Maximum Accumulated Remaining
Frequency Accumulated Remaining
Note

Claim eligibility for payment is determined at the time your claim is processed. The amount payable is based on and not limited to your plan design, deductibles, percentage paid by your benefits, maximums, coordination of benefits, etc. For more details, refer to your benefit booklet or contact our Customer Response Centre.

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