Service Type
Service Type
Select Provider
Claim Details - Dental
Claim Details - Health
Claim Details - Drug
Claim Details - HSA
Claim Details - Wellness
Claim Summary
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Recent Claims
Benefit
Sub Category
Patient Name
Submitted
Paid
Status
Service Date
Submitted Date
No claims found
Claim Types
Previous
Dental
Drug
Wellness
HSA
Health
Chiropractor
Physiotherapy
Massage Therapy
Other
| Health | Vision | Hospital |
Recent Providers
Name
Address
City
Province
According to our records, you do not have any recent providers on file. To add a provider to your claim, please use the Search for a Provider option.
Or
Attention: eClaim submissions must have a provider.
Click above in the search field to search and add your provider or pick a provider under recent providers. If you cannot find your provider, you will be prompted to add invoices to your eClaim to complete your submission.
| Name | Address | City | Province |
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Lab fees are not eligible to be submitted online; Please submit the claim by mail or fax 1-866-613-0530.
Lab fees are not eligible to be submitted online.
Please Note: There is a per claim maximum of %m for dental online claims submissions. Claims exceeding this amount will be pended for adjudicator review. All invoices must be uploaded with the claim.
To access a dental claim form, visit the "Forms" library located on the Home Page or simply "click here"
You currently have {0} left in your Health Spending Account.
Balance is as of Midnight (EST). Claims processed today will be reflected on the next business day.
Patient
Specialist
Total Charges
Please Note: There is a per claim maximum of %m for drug online claims submissions. Claims exceeding this amount will be pended for adjudicator review. All invoices must be uploaded with the claim.
Patient
DIN
Quantity
Dispensing Fee
Amount
Patient
DIN
Quantity
Dispensing Fee
Amount
Please Note: There is a per claim maximum of %m for Extended Health Care online claims submissions. Claims exceeding this amount will be pended for adjudicator review. All invoices must be uploaded with the claim .
You currently have {0} left in your Health Spending Account.
Balance is as of Midnight (EST). Claims processed today will be reflected on the next business day.
Patient
Service Type
Amount
Please Note: You currently have {0} left in your Health Spending Account.
There is a per claim maximum of {0} for HSA online claims submissions. Claims exceeding this amount will be pended for adjudicator review. All invoices must be uploaded with the claim.
Balance is as of Midnight (EST). Claims processed today will be reflected on the next business day.
Please Note: The current balance in your Wellness account is {0}.
There is a per claim maximum of {0} for Wellness online claims submissions. Claims exceeding this amount will be pended for adjudicator review. All invoices must be uploaded with the claim.
Balance is as of Midnight (EST). Claims processed today will be reflected on the next business day.
Please remember to submit your claim for consideration under your regular Drug, Dental or Extended Health benefits first.
Patient
Service Type
Benefit
Amount
| Dispense Date | Patient | Drug Name | Submitted Amount |
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| Service Date | Patient | Specialist | Submitted Amount |
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| Service Date | Patient | Service | Submitted Amount |
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Note
Should supporting invoice(s)/documentation be required to process your claim, you must supply an electronic copy of those invoice(s)/documentation along with the submission of your eClaim.
We cannot accept separately submitted supporting documentation arriving by fax, email or the postal system.
Note: To submit your invoices and/or documentation electronically you will need to digitize your images using a scanner or the camera feature on your cellphone.
We cannot accept separately submitted supporting documentation arriving by fax, email or the postal system.
Note: To submit your invoices and/or documentation electronically you will need to digitize your images using a scanner or the camera feature on your cellphone.
Unrecognized Provider
