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Need to submit a benefits claim, but not sure where to start?
Submitting your claim can be as easy as this: submit your claim and get your money back.
Depending on the level of complexity, some claims may need more time and/or information to process. We encourage you to get an estimate or pre-determination before you spend your money on high claim cost items, like medical equipment/services, expensive dental work or drugs that need pre-approval. That way, you know upfront whether your claim will be approved and/or how much will be reimbursed to you.
Follow these steps when submitting a benefits claim.
Step 1: Submit your claim
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Submit your claim online |
The provider submits your claim |
Submit your claim by mail |
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Cut out the mailing time and postage costs by submitting your claim online. |
Most pharmacies and dentists’ offices can submit your claim directly to the insurer. |
Mail your claim using the forms available. |
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Based on the type of claim and/or your benefits plan, you may need to attach your doctor’s note, physician’s referral, prescription, invoice and any other supporting documents. You can do this online or include the documents in the envelope with paper claims. NOTE: You are only required to submit a health and dental receipt if prompted to do so. |
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Step 2: Deposit your claim payments
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Direct deposit |
Cheques |
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Your claims reimbursement will be deposited directly into your bank account. |
Deposit your cheques at the bank or online. |
Once your claim has been received, it may take 5-7 business days to process.
For coverage related eligibility, you can review your benefits booklet in My Library. Per your benefits booklet, reasonable and customary limitations, maximums, coinsurance, and deductibles will affect the amount that is paid back to you.
If you have more than one family benefits plan, co-ordination of benefits can help you. When you link your plans together, you and your spouse/children (dependants) can get up to 100% of your money back for your health and dental costs.
NOTE: If you have single coverage, co-ordination of benefits does not apply to you.
Questions? We’re here to help. Contact OTIP Benefits Services at 1-866-783-6847. You can also visit our www.otip.com to access our Help Centre.
Related articles: Helping to prevent benefits fraud.