Here are five quick tips for managing claims when using your benefits:
Get an estimate.
Just like any big-ticket item you purchase (e.g. fridge, car, trip, insurance, etc.) for yourself or your family, you more than likely ‘shop around’ to get an estimate before you spend your money.
When it comes to your benefits coverage, it’s important to know that anything you can submit a claim for, you can submit an estimate for. Common services/products to consider submitting an estimate for include:
medical equipment/services over $300
drugs that need preapproval
expensive dental work
prescription glasses/contact lenses
You can do it online in My Claims. This way you will know upfront if your plan will cover the cost and how much you might have to pay out-of-pocket.
Be sure to also ‘View list of providers not covered’ under the Wellness centre in My Claims.
Add supporting documents to an existing claim.
Based on the type of claim you submit and/or your benefits plan, you may need to attach your doctor’s note, physician’s referral, prescription, diagnosis, invoice and any other supporting documents. You can attach supporting documents when you submit a claim or after you have submitted a claim. (See above image.)
Check your available balances.
You can use your benefits booklet to find out what your maximums are for your health and dental benefits. Once you start using benefits like massage therapy, buying glasses or hear aids, or seeing your chiropractor, you will want to know what coverage you have left. You can do this by logging into OTIP’s secure member site, accessing My Claims, and checking what your available balances are for Dental, Paramedical and Vision.
Check the status of a benefits claim.
Typically, you will get an email if your claim was successfully processed including the amount you have been reimbursed for. However, you can always check the status of a claim or view your claims history at any time in My Claims.
Waiting for your benefits claim cheque in the mail? With direct deposit, you get your money back faster and deposited right into your bank account. Sign up for direct deposit now!
Update your home/mailing address.
Just moved? Congratulations! You will need to contact your school board/employer to update this information. You will not be able to update your new address in My Benefits or My Claims. Since this new information will be sent to OTIP from your school board/employer, this change may take up to 10 business days before it is updated in My Benefits and My Claims.
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