Results for FAQs (69)

Here are some tips in navigating our interactive phone system:  VOICE ID Do you want to set up a voice ID? If not, you can say ‘No’ when they ask, “Are you ready?”.   How long does it take? It will

For details about your life, disability or accidental death and dismemberment coverage with GS360, please contact our Customer Care Centre at 1-888-711-1119.

You can update your premiums payment information online within your online account. Please follow these steps:  Website: Once logged into your online account, click on your name in the top right

Each insurance carrier has their own unique administrative guidelines, which govern how a carrier processes claims within a plan design. Reasonable and customary (R&C) limits are one example of a

In order to submit claims electronically* through your online account, you must register for direct deposit for your claim payments. Cheque payments will not be issued for online claims.   With this ‘

Offered to you and your dependants (age 16 and over) if you have the GSC mental health/counselling services benefit, the MindBeacon Therapist Guided Program is an effective, easy-to-access way to

Ontario A standard CPAP machine may be a benefit of your plan if you qualify for provincial funding through the Assistive Device Program (ADP). Please contact your supplier to confirm your eligibility

An orthotic is an orthopedic device designed to treat or adjust various biomechanical foot disorders. A custom-made orthotic is specifically crafted to meet the needs of a particular individual. This

Sometimes cash isn’t an acceptable form of payment – from time to time, when processing claims, valid traceable and identifiable proof (confirmation) of payment is required. What does that mean? It

Oops…. Sorry about that, our system had an error. Let’s try and fix it! Please take a screen shot of the error (usually CTRL + Print Screen on your keyboard) and email it over to us at

If you require additional physiotherapy treatments over 20 visits, a ‘Patient Progress Report for Continued Treatment’, completed by your physiotherapist, is required for review. Approval is based on

  Most dental association in each province publishes and updates a fee guide annually. Each guide contains a list of all the procedures that general practitioners can perform with a suggested fee or

Most plans have benefit booklets. If your plan has a booklet, you can view your benefit booklet through your online account by following these steps: Website: Once logged in to your online account,

This statement provides information that may be required for tax purposes (like the information provided on a receipt) as well as any deductibles, maximums, or co-payments applied to the payment of

Every dental procedure has a corresponding procedure code. In order to confirm eligibility for specific procedures we need the actual procedure code(s) and tooth number(s) (if applicable) for each

When multiple fillings or periodontal (gum) services are done at one appointment, there may be a reduction in time spent by the dentist and therefore the benefit should be passed along to the patient

We know other insurance companies use both policy and group numbers.  We have good news; we only use one! We use one number (we call it an identification number) which includes your dependent number.

Instead of returning your receipt to you, GSC produces an Explanation of Benefits (EOB) statement. This statement provides information that may be required for tax purposes (like the information

Changing your email address is simple, using these steps: Website: Log in to your account and click on your name, located in the top right corner of the page. Select “Your GSC Account”. Select “What

In order to process your claim, we require a traceable transaction which proves the disbursement of funds. Valid forms of identifiable confirmation (proof) of payment include:   A cancelled cheque (a

A DIN is assigned to a drug product by Health Canada before it reaches the market. The eight-digit number tells you the product has been approved for use and can legally be manufactured and sold in

We can re-issue a replacement cheque two weeks from the date the original cheque was issued. To avoid this in the future, we suggest you register for an online account and sign up for direct deposit.

Every plan is unique and created with different dollar maximums, benefit eligibility and frequency limitations agreed upon between your plan sponsor and GreenShield.  The item or product you claimed

Paper claim forms are only required if you are mailing your claim through the postal service.   You can download and print a personalized claim form by following these steps: Log in to your account

There are various exam codes that a dentist may perform and some of these procedures share the same frequency which might affect eligibility.   We recommend that you verify your coverage prior to

In order to take full advantage of Online Services, you will require Adobe® Acrobat® Reader®. To download Adobe® Acrobat® Reader®, please click here 　 Still cannot view your statements?  If you are

For claims that are submitted online for immediate processing, the claim is complete as soon as you receive confirmation that the claim has been processed. You will receive an email advising you that

To set up Touch & Face ID on your GSC everywhere app, please follow these steps:   Sign into the app with your username and password. Click on the hamburger menu titled “More” located at the bottom

Our front counter is available for walk-ins on Tuesdays and Wednesdays, 8:30 a.m. to 4:30 p.m.  If your preference is to drop off your claims, our drop box is available via a mail slot on the outside

Not all health and dental benefits plan are the same. It is important to verify with your human resources department or benefit administrator as to whether you are covered during your leave.

Greenshield specializes in health and dental coverage; therefore, we do not administer your short and long term disability benefits or life insurance. Please contact your employer’s human resources

There are a few possible situations – we can help with all of them. Just send us an email or call us at 1.844.554.2522. There are some medications that require GSC Special Pre-Authorization, but don’t

Many providers can bill us directly! You can search our provider directory using these steps: If you’re using the website: Once you are logged in to your online account, in the ‘Find Provider’ section

Foot care services are performed by either a podiatrist or a chiropodist.   A chiropodist is a specialist in treating minor ailments of the feet. Chiropodists are not graduate physicians and their

If you have a Health Care Spending Account and would like to view your Health Care Spending Account (HCSA) contributions and current balance, please follow the steps below. Website:   Login to your

If you think you have been overpaid on your last statement, you will need to contact one of our contact center agent. Depending on the amount of the claim and if the cheque was cashed or the money

The copay is the portion of a claim expense for which the plan member is responsible to pay. Your plan pays a certain % of your expenses based on GSC’s reasonable and customary amount and the

In order to be considered, claims must be received by GreenShield within 12 months of the date of service (unless otherwise stated in your benefit plan documentation).

If the claim for your mask was denied asking for a prescription, that means that we do not have anything on file for you indicating you have a PAP (CPAP, BiPAP, APAP) machine. You can submit one of

You may be able to change your address using these steps: Website: Log in to your account and click on your name, located in the top right corner of the page. Select “Your GSC Account”. Select “Who

The app is free to download and use if you are a GSC plan member. Data charges from your wireless carrier may apply if you are not connected to a Wi-Fi network.

Need a claims history report for income tax purposes? You can obtain a claims history report through your online services account by following these steps: Please make sure that you are logged in to

The first time a plan member tries to submit a claim through PMOS, the site will require that you must first accept the Web Claim Submission Agreement.   In choosing to submit claims via Online

On October 17, 2019 the production and sale of edible cannabis, cannabis extracts and cannabis topicals became legal in Canada under the Cannabis Act.  The product can be found at provincial and

We keep our fingers on the pulse of health and dental benefits and services in the Canadian health care system.  When the cost of these benefits and services increases, we need to adjust your rates.

Changing your user name is simple, using these steps: Website: Log in to your account and click on your name, located in the top right corner of the page. Select “Your GSC Account”. Select “What do

Changing your password is simple, using these steps: Website: Log in to your account and click on your name, located in the top right corner of the page. Select “Your GSC Account”. Select “Change your

GSC performs periodic reviews on health care providers’ claims and business practices, to ensure that you are receiving services or products from accredited and approved service providers.   If you

Our app provides you with a mobile version of your benefit ID/travel card.  You can access your ID card one of two ways: Before logging in to the app, there should be an “ID Card” button in the

To view your Personal Spending Account (PSA) deposits and current balance, please follow these steps:   Login to your account and click on your name, located in the top right corner of the page.

Changing your security question is simple, using these steps: Website: Log in to your account and click on your name, located in the top right corner of the page. Select “Your GSC Account”. Select “

If you are using GSC on the Go the session will timeout after 15 minutes of inactivity.

Changing your phone number is simple, using these steps: Website: Log in to your account and click on your name, located in the top right corner of the page. Select “Your GSC Account”. Select “Can we

As you may recall, we updated our phone system last summer to enhance your experience when you call Greenshield (GSC). Since then, we have received some great feedback and we continue to upgrade the

As it turns out, your pharmacy submitted multiple times for your medication. It is not uncommon for a pharmacy to transmit a claim several times if they need to make an adjustment to the quantity or

When your pharmacy submits a medication claim, they indicate the number of tablets as well as the number of days that the prescription was written for you. Your benefit plan allows you to refill your

Itemized prescription drug receipts from your pharmacist. Receipts must contain: Patient's name Date of service Prescription (Rx) number Drug name Quantity dispensed and, Drug Identification Number (

Reimbursement for your prescription medication was reduced to the price of the lowest cost alternative drug. Depending on your plan, reimbursement may be limited to the price lowest cost alternative (

What is a Drug Formulary? A formulary is a list of drugs eligible for reimbursement. There are 3 types of formularies offered at GreenShield: Open, Tiered and Managed.   What is an Open Formulary? An

To check if you are eligible, select the “Am I Covered” option in the left menu and follow the steps to check eligibility. Note: currently, you are only able to check coverage for a brace with a

A Health Care Spending Account can be used alone or in combination with a traditional benefit plan. Items and services are considered eligible benefits of your Health Care Spending Account if they

Please refer to the benefit booklet provided by your employer for a complete breakdown of your dental coverage. Your dental office can also submit an estimate electronically through their software to

Scaling and root planing involve removing calcium deposits (plaque, tartar, calculus, stone) from around the tooth, both above and below the gum line. One unit of scaling or root planing consists of

A Dental Accident (DA) is an accidental injury to natural teeth caused by a direct blow to the mouth that is not by an object consciously or unconsciously placed in the mouth (i.e., eating) that

Your plan has an allowed amount that is eligible for reimbursement for each drug. This is based on a calculation that incorporates the drug cost, dispensing fee and markup percentage for the pharmacy.

A biosimilar is a biologic that comes to market after the originator drug. A “biosimilar” is a Health Canada-approved medicine that has the same positive health outcomes for patients as the originator

The maintenance medication policy requires pharmacists to dispense at least a 90-day supply for several maintenance drugs. Maintenance drugs are used to control and manage a variety of chronic or long

This highly effective program helps plan members currently taking one of the impacted originator biologic drugs to transition to the corresponding biosimilar product. This program applies in all

To check if you are eligible, select the “Am I Covered” option in the left menu and follow the steps to check eligibility. Continue reading below for more information. If a TENS machine is included in