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Making a claim

[1] Claiming expenses incurred outside of the McGill Health Clinic
[2] If you make a claim but receive no response from Blue Cross
[3] Reimbursement for basic health benefits
[4] Contacting Blue Cross
 


Claiming expenses incurred outside of the McGill Health Clinic - 4 ways to make a claim

 

Please note: receipts must contain the following information:

  1. the type of procedure that took place;
  2. the cost of the procedure;
  3. the "Quebec Code": a four- or five-digit number associated with the exact procedure(s) that took place;
  4. the diagnosis; and
  5. the name, address and license number of your physician.

 

If you make a claim but receive no response from Blue Cross:

Whenever you send a claim to Blue Cross, you will receive a reply -- even if your claim is rejected. If Blue Cross refuses your claim, you will receive a report explaining why. If you receive no response within 30 days, it may be because Blue Cross never received your claim, because you submitted an incomplete claim, or because their response was sent to the wrong address. You should contact Blue Cross at 1-888-588-1212 if you have been waiting for a month or more.

Should you need to re-submit a claim, this will be much easier if you have photocopies of your receipts. Obtaining duplicate receipts from a health care provider or pharmacy can be time-consuming or even impossible.

As well, it is very important to update your address and phone numbers in Minerva, since changes you make in Minerva are sent to Blue Cross each week. Also, be sure to write your address carefully on the claim form, including your apartment number and postal code. If you plan to move, you should send Blue Cross a letter that includes your current address, the date of your move and the new address.


Reimbursement for basic health benefits

Basic health benefits are payable at 100% and charges are paid by Blue Cross in accordance with the Quebec Provincial Schedule of Fees. This Schedule determines the cost of every medical procedure covered by Quebec's provincial health plan. Blue Cross uses this same schedule to establish maximum amounts payable to claimants. For example, the cost of a general consultation with a family doctor is approximately $40.

Although Blue Cross determines its reimbursements according to the prices set in the Schedule, health care providers are entitled to charge more than the Schedule allows when treating patients who are not Quebec residents. As a result, Blue Cross may in some situations reimburse less than 100% of your basic medical expenses.

To avoid unpleasant surprises, ask your health care provider whether you will be charged the same rate as a Quebec resident before receiving any treatment. If an "international fee" or "administrative charge" is added, you should be aware that you will not be fully reimbursed.

We recommend that you use the McGill Student Health Clinic(only for McGill Students) for your medical needs whenever possible, as your Blue Cross card will be accepted there and you will not be charged. A list of medical clinics and health service providers close to McGill University is available here.


Contacting Blue Cross

If you have any questions regarding your claim, contact Blue Cross at 1-888-588-1212.