Beneva Inc.

Step-by-Step Guide to Filing Claims with Beneva Inc.

1. Choose Your Submission Method

Beneva offers four primary ways to submit claims:

• Online via Client Centre (Fastest and recommended)
• Mobile App (Convenient for on-the-go submissions)
• Direct Billing (For eligible healthcare providers)
• Mail (For non-digital claims)

2. Online Submission (Client Centre)

1. Log in to the Client Centre:
   • Visit Beneva’s Client Centre and sign in using your credentials. If you’re a new user, register with your plan number and member ID (provided by your employer or insurer)
2. Navigate to Claims:
   • Click “Submit a Claim” under the Group Insurance section.
3. Select Claim Type:
   • Choose from Health, Dental, Prescription Drugs, or Travel Insurance.
4. Upload Supporting Documents:
   • Attach scanned copies of original receipts, prescriptions, or completed forms (e.g., Health Services Claim Form)
5. Review and Submit:
   • Confirm details and submit. Most claims are processed within 48–72 hours

3. Mobile App Submission

1. Download the Beneva App:
   • Available on Google Play or the App Store.
2. Sign In or Register:
   • Use your Client Centre credentials.
3. Submit Claims:
   • Tap “Submit a Claim”, select the category (e.g., paramedical, dental), and upload photos of receipts directly from your device
4. Track Status:
   • Monitor progress in the app’s “Claims History” section

4. Direct Billing (For Eligible Providers)

‍If your healthcare provider participates in Beneva’s direct billing program:

1. Confirm Eligibility:
   • Providers like massage therapists, chiropractors, and physiotherapists can bill Beneva directly if registered with TELUS Health eClaims
2. Present Your Insurance Card:
   • Provide your Beneva insurance card at the appointment. The provider will handle the claim submission electronically.
3. Pay Only the Uncovered Portion:
   • You’ll pay any co-pay or non-covered fees directly to the provider

5. Mail Submission

1. Download the Correct Form:
   • Use the Health Services Claim Form for medical/dental claims or the LTD Claim Form for disability claims
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, and patient’s name
4. Mail to Beneva:
   • Address: Beneva Inc., Group Insurance Claims Department, [Insert mailing address from your policy documents].

6. Special Cases

• Long-Term Disability (LTD) Claims:
  • Submit the Employer Statement, Employee Statement, and Attending Physician’s Statement via the Client Centre or mail. Processing takes 5–20 days
• Travel Insurance:
  • Contact Beneva’s international assistance service at 1-866-783-9473 (Canada/US) or 514-285-8195 (collect call) before incurring expenses. Submit claims online afterward

Key Requirements & Tips

• Deadline: Submit claims within 12 months of the service date
• Direct Deposit Enrollment: Speed up reimbursements by enrolling in direct deposit via the Client Centre
• Coordination of Benefits: If covered by multiple plans, submit to the primary insurer first (e.g., employer plan), then to Beneva for secondary coverage

Tracking Your Claim

• Online Portal: Check status under “Claims History” in the Client Centre
• Contact Support:
  • Phone: 1-877-841-8822 (Claims Department)
  • Email: Use the messaging system in the Client Centre

Troubleshooting Common Issues

• Claim Denied?
  • Ensure receipts are original (photocopies rejected) and forms are fully signed
  • Contact Beneva’s Customer Service at 1-800-463-4856 for clarification
• Delayed Processing:
  • Check for missing documents or policy reviews (common after 2 years of LTD benefits)

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Frequently Asked Questions (FAQs): Beneva Insurance

1. Does Beneva cover paramedical services at Panda Clinic?

Yes! Most Beneva group plans cover massage therapy, physiotherapy, acupuncture, and chiropractic care. Coverage limits vary by plan—check your policy or log in to the Beneva Client Centre to confirm your annual allowances.

2. Can Panda Clinic bill Beneva directly?

Yes, if your plan allows it. At your appointment:

• Provide your Beneva member ID and plan number (found on your insurance card).
• Pay only the uncovered portion (e.g., co-pay or non-eligible services).

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

• Original receipt from Panda Clinic (with service date, cost, and provider license number).
• Completed claim form (download from Beneva’s Forms page).
• Prescription or referral (if required by your plan, e.g., for physiotherapy).

4. How long does Beneva take to process claims?

• Online/mobile submissions: Processed in 2–5 business days.
• Mail submissions: Allow 7–10 business days plus mailing time.
  Tip: Enroll in direct deposit via the Client Centre for faster payouts.

5. What if my claim is denied?

‍Common reasons include:

• Missing receipts or incomplete forms.
• Exceeding annual coverage limits.
• Services not eligible under your plan.
  Contact Beneva at 1-877-841-8822 or message them via the Client Centre to resolve issues.

6. Can I combine Beneva with another insurance plan?

‍Yes! Beneva allows coordination of benefits with a spouse’s or secondary plan. Submit to your primary insurer first, then to Beneva for remaining costs. Provide both policy details to Panda Clinic for seamless billing.

‍7. How do I check my remaining coverage?

• Log in to the Beneva Client Centre → Navigate to “My Coverage”.
• Call Beneva’s support line: 1-800-463-4856.
• Ask our Panda Clinic team—we can often check your balance during appointments!

8. What’s the deadline to submit claims?

‍Claims must be filed within 12 months of the service date. Exceptions apply for travel insurance (submit within 90 days of returning home).

‍9. Do I need a referral for massage therapy or acupuncture?

‍Most Beneva plans do not require referrals for paramedical services. However, some employer-sponsored plans may ask for a doctor’s note—confirm in your policy documents.11. Can I track my claim status online?Yes! Log in to the Client Centre and go to “Claims History” for real-time updates. You’ll also receive email notifications.

‍10. How do I submit travel insurance claims?

1. Before traveling: Call Beneva’s assistance line (1-866-783-9473) to pre-authorize emergency care.
2. After returning: Submit receipts and a completed Travel Claim Form online or by mail.

Still Need Help?

‍Contact Beneva directly:

• Claims Support: 1-877-841-8822 (Mon–Fri, 8 AM–8 PM ET)
• Email: Use the secure messaging system in the Client Centre.
• Panda Clinic Assistance: Email us at health@pandaclinic.ca for help with receipts or forms.