To protect and sustain your benefits coverage under your Employee Life and Health Trust (ELHT) Benefits Plan, Manulife, the claims payor, sometimes finds it necessary to disallow certain service providers/suppliers from claims processing and reimbursement. This is referred to as being “delisted”.
Claims submitted from these providers/suppliers, who are not in good standing with your claims payor, will not be approved or reimbursed.
If a service provider/supplier you have previously used has been identified as a ‘delisted’ provider, Manulife will send you a notification. This notification will include the date they have been delisted. If you submit any eligible claims with dates of service before the delisted date, the claim will be processed. If the date of service is on or after the delisted date, the claim will not be approved or reimbursed.
To avoid delays in processing your eligible claims, be sure to check the delisted providers list before making an appointment to ensure your new and current providers/suppliers are in good standing. The delisted provider listing is updated regularly. Therefore, if the provider/supplier is on the delisted providers list, these claims will not be approved or eligible for reimbursement. Before booking your appointment, you can also ask the provider/supplier if they are in good standing with Manulife.
Just by checking the list or talking to your provider you could avoid surprises, disappointment and money out of your pocket.
Please see our frequently asked questions below for more information.
|
Question
|
Answer
|
|
What if I submit a claim with a date of service before the provider was delisted?
|
If the claim is eligible for reimbursement and the date of service is before the delisted date, the claim will be approved and reimbursed.
|
|
What if I went to see the provider and did not know that they were on the delisted list? What if I submit a claim with a date of service on or after the provider was delisted?
|
The claim would not be approved or reimbursed under your benefits plan.
IMPORTANT: Providers/suppliers are required to tell you if they have been delisted by Manulife. It is recommended that you check the delisted providers list before making an appointment to ensure your new and current providers/suppliers are in good standing.
|
Questions? We’re here to help. Visit otip.com/Help-Centre to learn more about claims for delisted providers, or contact OTIP Benefits Services at 1-866-783-6847.