Important information regarding submitting claims:
It is important that all forms be completed in full, including the appropriate identification number and payment receipts, to avoid delays in processing claims. We recommend you keep a copy of all items submitted.Ìý
All claims must be submitted to GreenShieldÌýwithin 12 months from the end of the calendar year in which the expenses were incurred to be eligible for reimbursement.
For example, all eligible expenses incurred in 2024 must be submitted by the end of 2025.ÌýOn any occasion when a significant expense is expected, employees are encouraged to submit a cost estimate or predetermination/treatment plan to GreenShieldÌýbeforehand. This can be done by having the practitioner provide a predetermination of benefits. Procedure coverage and reimbursement amounts will be communicated by GreenShieldÌýdirectly to the member.
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GreenShield has multiple options for claims submission:
- Self-Service online claims: Through this service, you pay for the medical product or service, then submit your claim online through the or app. Please refer to the Online Claims Facts sheet for additional information, or see the steps listed below.ÌýNote: You must register your account with the GreenShield+Ìýmember site (or app) to submit a claim online or through the app.Ìý
Ìý - Direct billing through your provider (provider submits claims on your behalf): Many health service providers will electronically submit claims on your behalf. As of January 1, simply present your GreenShieldÌýbenefits ID card and ask them to submit your claims directly to GreenShield. All the information they will require for direct billing is on the card. If they have any difficulty with registration or claims submission, have them call GreenShieldÌýCustomer Contact Centre.
Ìý - Paper claims: For claims that are not submitted electronically, either by you or your provider, simply pay for your item or service and mail the paid receipt and claim form for reimbursement to GreenShieldÌýat the address indicated on the claim form.ÌýÌý
- Personalized GreenShieldÌýclaim forms are available online through Ìý
- ÌýÌýÌý
- Medical forms on the HR forms webpage
- To have a form mailed to you, call the GreenShieldÌýHelp Centre listed belowÌý
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Claim submission step guides:
The following documentation on the GreenShield support centre shows the steps you can follow to submit a claim.Ìý Questions about how to submit a claim should be directed to GreenShield.ÌýÌý
Step 1
It is extremely advantageous to know what your policy does and does not cover in advance of costÌýso you can know what charges you will incur.
Step 2
Once you have determined you are eligible for an expense, the procedure on how to submit a claim is listed in Step 2.Ìý
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Select the appropriate paramedical service for your claim:
When submitting claims through GreenShield+, the appropriate paramedical service type must be accurately selected based on your provider's designation. If the wrong service type is selected, your claim may be denied and re-submission with the correct service type may be required.
Designations can be found on your receipt from our provider and are typically found next to your provider's name. If there is no designation listed on the receipt, contact your service provider to confirm their designation.
Service Type | Designation |
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Masters of Social Worker | MSW - Masters of Social Work |
Psychologist | Ph.D. - Doctor of Philosophy Psy.D. - Doctor of Psychology Ed.D. - Doctor of Education D.Clin.Psy. - Doctor of Clinical Psychology D.Clin.Psychol. - Doctor of Clinical Psychology D.Clin.Psych. - Doctor of Clinical Psychology D.Ed. - Doctor of Education D.Litt et Phil. - Doctor of Literature and Philosophy D.Ps. - Doctor of Psychology D. Psych. - Doctor of Psychology Dr. rer, Nat. - Doctorate in Natural Sciences M.A. - Master of Arts M.Ed. - Master of Education M.Sc. - Master of Science M.A.Sc. - Master of Applied Science M.App.Sc. - Master of Applied Science M.Sc.Ed. - Master of Science Education M.Phil. - Master of Philosophy MPhil. - Master of Philosophy M.C. - Master of Counselling Dip. Couns. Psychol. - Diploma of Counselling Psychology B.A. - Bachelor of Arts |
Psychotherapist | Registered Psychotherapist (RP) |
Eye Exam | If you had a routine/standard eye exam (also known as oculo-visual assessment) available every two years |
Diagnostic Vision Test | All Other Exams that are not routine/standard |
Please note:Ìýthis list is not inclusive of all designations/services eligible under the plan.
It's important that the designation of the provider you visited is used as the Service Type, rather than the services that they performed for you.Ìý For example:
- If you obtained counselling services from a mental health provider with a MSW designation, select Masters of Social Work.
- If you obtained counselling services from a mental health provider with one of the 22 Psychologist designations, select Psychologist.
- If you obtained counselling services from a mental health provider with a Registered Psychotherapy (RP) designation, select Psychotherapist.
- If you obtained counselling services from a mental health provider without one of the above designations, your expense is not eligible for reimbursement through the extended health benefit.
If you cannot locate your provider, they are not registered with GreenShield and you will not be able to submit your expense through GreenShield+.Ìý Please contact GreenShield with your provider's contact information (either through the contact centre or by paper claims submission) so that GreenShield can connect to your provider to obtain a copy of their designation. The provider's credentials will need to be obtained before your expense can be adjudicated.
If you require any assistance during this process, please reach out toÌýGreenShield directly.
Contacting GreenShield:
PhoneÌý(Mon to Fri, 8:30 a.m. - 8:30 p.m. ET):
- 1-888-525-7587, select "Option 1", orÌý
- 1-888-711-1119Ìý
Online:Ìý
- customer.service@greenshield.caÌýÌý
- GreenShieldÌý
- : an online hub with answers to commonly asked questions
Inquiry support:Ìý
Experiencing problems with a benefit claim?
The following steps of the GreenShield Inquiry Support Model can help to resolve the problem.Ìý