Do you need help with submitting claims for a Specially Insured Patient?
The team at Dr.Bill is happy to help!
Billing Support for Specially Insured Patients
Dr.Bill is pleased to offer Billing Support for your Specially Insured Patients in the following programs:
Medavie Blue Cross - Interim Federal Health Program (IFHP) for Refugee patients
Medavie Blue Cross - Canadian Armed Forces (CAF) for Military patients
Federal Inmates – Any Inmate residing in a Canadian Federal Institution
Cowan Insurance - University Health Insurance Plan (UHIP) for International Students in Ontario Universities
Our pricing structure for these claims does depend on your active subscription plan with Dr.Bill. Please see below for additional details:
Comprehensive
25% Service Fee of Recovered Funds
Essentials
25% Service Fee of Recovered Funds + $20 Administration Fee (per claim)
What Information do I need?
Each Specially Insured Patient will have a Policy number so their medical claims can be billed to their corresponding insurance plan.
Below you will find what type of Policy number is required for Billing Support on your Specially Insured Patient Claims.
This information is mandatory – please ensure to include it on your claim before notifying our team for Billing Support.
Refugee - IFHP:
Requires a Unique Client ID otherwise known as a UCI number. This will be 8-10 digits (ex: 123456789).
Military - CAF:
Requires a Military ID number. This number will start with an M and be followed by 8 digits (ex: M12345678).
Federal Inmates:
Requires the name of the Federal Institution only. No Policy or Prison ID is required.
UHIP:
Requires the patient University ID and Policy Number. The Policy number will likely be 6 digits (ex: 150150) and the University ID starts with 1 or 2 letter(s) followed by several digits (ex:YU123456789).
How do I submit a Claim for Billing Support?
Step 1: Create the new patient under “Private” (instead of Public).
In the “Policy Number” section, enter the patient’s insurance Policy number. If you’re billing a Federal Inmate, you can input “Inmate”.
If the Policy number doesn’t fit, you can enter it in the Notes section below.
Step 2: Continue entering the remaining patient demographics and claim information.
When you get to the “Note” section; enter a message to request Billing Support.
If you couldn’t enter the Policy Number previously, add it here. If you’ve added a claim for a Federal Inmate, include the name of the Federal Institution.
Example: “Refugee UCI 1123456789 – Requesting Billing Support”
“Inmate at Kent Institution – Requesting Billing Support”
*If you're billing in Alberta, you may not have a "Note" section when entering your claim. Please continue to Step 3.
Step 3: Once you’ve provided the all the information above, write into us at hello@dr-bill.ca to let us know you’ve added a claim for Billing Support. To identify the claims, you may:
· Send the URL(s) of the claim(s)
OR
· Let us know the Patient Initials, Date of Birth and Dates of Service
Failure to complete any of the above steps, may result in your claim not being processed. We are not able to process claims without the patient policy number (except for Federal Inmates).
We cannot modify a submitted claim. If you’ve made a mistake, please let our team know as soon as possible. We have limited time to Cancel a claim after Submission.
What Happens After I Submit a Specially Insured Patient Claim?
Once you’ve entered your claim successfully and notified our team, we will submit your claim to the corresponding insurance within 1-5 business days. When your claim is submitted, we will write a note on the claim timeline, stating the submitted date along with the submitted amount.
Your claim may stay in the “Pending” or “Submitted” status until payment.
If we have any questions or require additional information, our Billing Agents will reach out to you on the Claim Timeline or by email.
Once we receive payment for your claim, we will mark the claim as Paid on your Dr.Bill account.
We will then send you an e-transfer (to your email on file) for the amount paid by the insurance (less the 25% Service Fee). There will be a payment summary attached to the e-transfer, so you know which claims were paid.
In addition, we will notify you 1-5 business days before you receive the e-transfer so you know when to expect the funds.
Fee Rates:
We will adjust any fee rates as necessary before submitting your Private claim.
Medavie Blue Cross: Provincial Fee rates
UHIP: 1.25x the Provincial Fee rates
Federal Inmates: Private Fee rates for BC and ON. AB Provincial Fee rates only.
Submission Cut-off
Refugee - IFHP:
180 days from the date of service
Military – CAF
18 months from the date of service
UHIP:
No cut off if the student’s coverage is active at time of submission