Alberta Blue Cross

Step-by-Step Guide to Filing Claims with Alberta Blue Cross

1. Choose Your Submission Method

Alberta Blue Cross offers three primary ways to submit claims:

• Online (Member Site or App)
• Mobile App (iPhone/Android)
• Mail (Paper Forms)

2. Online Submission (Recommended for Speed)

1. Log in to the Member Portal:
   • Visit Alberta Blue Cross Member Site or download the Alberta Blue Cross® Member App
2. Navigate to Claims:
   • Click the “Submit a Claim” link on the dashboard.
3. Select Claim Type:
   • Choose from Extended Health (e.g., paramedical, vision), Prescription Drugs, or Dental
4. Upload Supporting Documents:
   • Attach scanned copies of original receipts and any required forms (e.g., Health Services Claim Form).
5. Review and Submit:
   • Confirm details and submit. Claims are typically processed within 5–20 days

3. Mobile App Submission

1. Download the App:
   • Available on the App Store (iPhone) or Google Play (Android)
2. Sign In:
   • Use your member credentials.
3. Submit Claims:
   • Tap “Submit a Claim” and follow prompts to upload receipts and forms.
4. Track Status:
   • Monitor progress in the app’s “Claims” section

4. Mail Submission (For Non-Digital Claims)

1. Download the Correct Form:
   • Extended Health/Drugs: Use the Health Services Claim Form
   • Dental: Use the Dental Claim Form
2. Complete the Form:
   • Fill in personal details, provider information, and service dates.
   • Sign and Date the form.
3. Attach Original Receipts:
   • Ensure receipts include:
     • Provider name
     • Date of service
     • Cost of service
     • Patient’s name
4. Mail to Alberta Blue Cross:
   • Address: Alberta Blue Cross®, 10009-108 St. NW, Edmonton, Alberta T5J 3C5

5. Direct Billing (For Paramedical Services

)If your provider (e.g., massage therapist, chiropractor) offers direct billing:

1. Confirm Eligibility:
   • Ask your provider if they participate in Alberta Blue Cross’ direct billing program
2. Provide Your ID Card:
   • Show your Alberta Blue Cross ID card at the appointment.
3. Pay Only the Uncovered Portion:
   • The provider bills Alberta Blue Cross directly; you pay the remaining balance (e.g., 20% co-pay)

Key Requirements & Deadlines

• Deadline: Claims must be submitted within 12 months of the service date
• Documentation: Always include original receipts and signed forms (photocopies are not accepted)
• Direct Deposit Enrollment: Speed up reimbursements by signing up for direct deposit via the member portal

Tracking Your Claim

• Online Portal: Check status under “Claims” in your member account
• Contact Support:
  • Phone: 1-800-661-6995 (toll-free)
  • Email: Via the member portal’s messaging system

Frequently Asked Questions (FAQs)

1. How do I know if my insurance covers Panda Clinic’s services?

Check your insurance plan’s paramedical coverage section or contact your provider directly. Most plans (e.g., Alberta Blue Cross, Sun Life) cover services like massage therapy, acupuncture, and physiotherapy. You can also view our list of covered providers for quick reference.

2. Does Panda Clinic offer direct billing?

Yes! We directly bill most major insurance providers, including Alberta Blue Cross. At your appointment, provide your insurance card and let our team handle the rest. If your provider isn’t listed, we’ll give you a detailed receipt to submit manually.

3. What documents do I need to submit a claim?

• Original receipt from Panda Clinic (includes service date, cost, and practitioner details).
• Completed claim form (downloadable from your insurer’s portal).
• Proof of payment (if paying upfront).
  Tip: Keep copies of all documents for your records.

4. How long does it take to get reimbursed?

• Direct billing: Claims are processed instantly, and you pay only the uncovered portion at your appointment.
• Manual submission: Most insurers (e.g., Canada Life, Medavie Blue Cross) process claims in 5–20 business days. Enroll in direct deposit with your provider for faster payouts.

5. What if my claim is denied?

Common reasons include:

• Missing or expired coverage.
• Exceeding annual limits.
• Incorrectly filled forms.
  Contact your insurer to resolve the issue, or reach out to Panda Clinic for assistance with appeals.

6. What if my provider isn’t listed on your website?

‍Contact us! We’re constantly updating our partnerships. Even if we don’t directly bill your insurer, we’ll provide all necessary documentation for manual claims.‍

7. Are there deadlines for submitting claims?

‍Most insurers (e.g., Great West Life, Equitable Life) require claims within 12 months of your appointment. Check your policy for exact timelines.

‍8. Do I need a doctor’s referral for paramedical services?

‍It depends on your plan. For example:

• Alberta Blue Cross Group Plans: Rarely required.
• Manulife: May require a referral for services like physiotherapy.
  Confirm with your insurer before booking.

9. Can I book online if I’m using insurance?

‍Absolutely! Select your service and insurance provider during booking. We’ll verify coverage and prepare your paperwork in advance.

‍Still Have Questions?

‍Contact our insurance support team at health@pandaclinic.ca or call 888-843-2716.
For insurer-specific details, visit our Insurance Guides page.