What are the "Top Five" reasons claims are delayed?
1. Original receipts and documentation have not been included with the claim form.
We cannot accept photocopies or faxed receipts or invoices. Cash register receipts will not be accepted.
Make sure to include:
- The first and last name of the person claiming the expense. Receipts not identifying who the expense is for will be subject to rejection. Cash register receipts are not acceptable.
- The date or dates on which service was obtained must be included.
- The provider's name and address.
When submitting receipts with your Health Services Claim Form:
- Drug expenses must show the drug identification number (D.I.N.)and quantity purchased.
- Purchase of other health items must be accompanied by a copy of the physician's written order.
- Out-of-country expenses must indicate the name of the country and, when possible, the translation of the product or drug name.
- Ambulance expenses must show the origin and destination of the trip.
Send completed forms to Alberta Blue Cross®, 10009 - 108 Street NW., Edmonton, Alberta T5J 3C5.
2. A Dental Treatment Plan (ABC 20041) hasn't been sent in.
If your dentist recommends treatment totaling more than $800, submit a Dental Claim/Treatment Plan form to Alberta Blue Cross® first to determine your coverage. Completed forms should be sent to Alberta Blue Cross®, 10009 - 108 Street NW., Edmonton, Alberta T5J 3C5. Your dentist may also submit this electronically.
3. A claim has been sent in after the claiming deadline.
Check your benefits booklet to find out your group's claiming limitation. All plans have a specific period of time in which you must submit expenses. Claims submitted after the claiming period will not be paid.
If your claim is complete and you have forwarded all the necessary receipts and documents, your cheque will be mailed, or funds directly deposited into your account, approximately two weeks after we receive your claim. Completed forms should be sent to Alberta Blue Cross®, 10009 - 108 Street NW., Edmonton, Alberta T5J 3C5.
4. The wrong claim form has been filled out.
Some of the most commonly used forms are listed below:
Dental Claim/Treatment Plan (ABC 20041)
- used for all dental claims including accidental dental services. Health Services claim form (ABC 20039) - used to submit claims for services such as private or semi-private hospital accommodation, ambulance, psychology services, physiotherapy, chiropractic, wheelchairs and hearing aids. (Note: use the Dental Claim/Treatment Plan form (above) for accidental dental. If the dentist thinks your dental services could cost over $800, use a Dental Claim/Treatment Plan form to submit a "Treatment Plan" before beginning treatment.)
Expatriate claim form (ABC 30735)
- use this form to submit expenses for health services obtained by employees working outside Canada . (Note: please complete a separate Expatriate claim form for for each person.)
Out of Province/Out of Country Claim Form (ABC 30741)
- use this form to submit medical expenses incurred while travelling. These could include ambulance, hospital, airfare or vehicle return. (Note: this form has two pages/sides which must be filled out. A separate claim form must be filled out for each person claiming. If you need reimbursement for services already paid, you must provide proof of payment such as a paid receipt or copies of both sides of your cancelled cheque. If you are not an Alberta resident, please submit all hospital and physician claims first to the claimant's provincial health plan for assessment, then to Alberta Blue Cross®.)
Over-age Dependent Declaration (ABC 30230)
- submit this form to declare 1) an unmarried child over the dependent age but under the maximum age specified in the Employee Benefits book who is attending an accredited educational institution on a full-time basis, or 2) an unmarried child, over the dependent age as specified in the Employee Benefits Booklet, but fully dependent due to mental or physical infirmity.
5. The form has missing information.
Check to see if the form has a second page -- and that you've signed the form!