To use Member eClaims, you must be registered for GroupNet™ for Plan Members and signed up for Direct Deposit of claims payments.
How Member eClaims Works:
You will see a ‘Submit a claim’ link under the Claims section once signed in to GroupNet™ for Plan Members. Claims can be submitted following these steps:
1. Select Type of Claim Submission Method
– If coordinating regular benefits and the HCSA, select Health, Drugs, Vision & Dental Plan Type.
– If only submitting a claim to the HCSA, select the HCSA/Medi-Dent Account Plan Type.
2. Select Type of Claim
– If you answer ‘yes’ to the question to reimburse any unpaid portion from your spending account, the claim will automatically be considered under the HCSA.
– If the claim is submitted only to the HCSA, you must select the check box that acknowledges you understand the claim will not be applied to any Health, Drugs, Vision or Dental plan.
3. Enter Provider information.
4. Select a Patient.
5. Enter in the Expense Details.
– If you answer ‘yes’ if the claim has been submitted to or paid in part by another group plan, you must enter the amount paid by the other insurance carrier in the box “Other Insurance Paid”.
6. Read and Agree to the ‘Terms and Conditions’ and the ‘Claim Summary and Consent’ sections.
7. View or Print the Confirmation and Summary of your online claim.
Once your claim has been adjudicated, you will receive confirmation via an email notification or text message to your mobile phone.
If your Great-West Life ID card is lost or misplaced, replacement cards can be requested online through the GroupNet™ for Plan Members site.
Tips to Completing Paper Claim Forms
For many employees, submitting claims for reimbursement can be confusing; from deciding which form to use, to where to find the required information. Submission of incomplete forms can cause delays in processing and payment.
The following are some tips to assist you when completing and submitting Great-West Life claim forms:
- All Health claims, including Vision claims, are to be submitted on a Healthcare Expense Statement.
- All Dental claims not submitted electronically by your Dentist are to be submitted on a Dentalcare Expenses Statement. Some Dentists may also use a Canadian Dental Association claim form, which is also acceptable.
- Claim forms can be found on Great-West Life’s website.
- Indicate at the top of the form if you would like this claim applied to the Healthcare/Dentalcare plan only, Health Care Spending Account only, or both.
- Your Plan Member ID Number is your RRC Employee number and can be found on your Great-West Life ID card.
- Attach all original receipts to the claim form. If you are coordinating with a spouse’s plan, attach the Explanation of Benefits (EOB) received from their insurance company.
- In the event a receipt is not available when purchasing glasses or contact lenses, Part 9 of the Healthcare Claim form can be completed by your Optometrist, Optician, or Ophthalmologist to be eligible for reimbursement.
- The claim form must be signed by the Employee, not the person(s) for whom the claims are being submitted.
- Make a photocopy of the claim form, receipts and any other attachments in the event the claim is lost in the mail. Originals will not be returned.
Direct Deposit for Claims Payments
You can have your benefit cheques automatically deposited to your account by Great-West Life using Direct Deposit.
With Direct Deposit, there are no payment delays due to mail disruptions, no chance of cheques being lost or stolen, and no need to deposit your cheques in person.
If you sign up for Direct Deposit, you will receive an e-mail notification when your claim has been paid. You will also have access to an online Explanation of Benefits.
Remember for faster claims submission, you can submit your own claims online through GroupNet.