Providers should verify client eligibility for IFHP and collect the information and documents needed for claims submissions to IFHP during each visit.
If your client is eligible for and registered under IFHP, ask them for their 8-digit Client ID number. This can be found on either their Refugee Protection Claimant Document or their Interim Federal Health Certificate. Using this Client ID number, verify the client’s current IFHP coverage by:
- Calling 1-888-614-1800 or
- Entering the Client ID number into the Provider Web Portal.
If your client does not have or know their Client ID number, provide their name and date of birth by phone at 1-888-614-1880 to determine their eligibility or current status.
If your client is eligible for but not registered under IFHP, provide them with the IFHP Client Application information – see Applying for Client IFHP Coverage.
Note that it takes two business days from the day that IFHP eligibility documents are issued for the information to be reflected in the Medavie Blue Cross system. Clients are still eligible during this two day period, but providers should delay submission to Medavie Blue Cross until two to three business days after the effective date listed on their documents.
If your client is eligible for OHIP coverage, do not bill for OHIP-covered services via the IFHP system, as these claims will be rejected.
Submitting a Claim to IFHP:
Claims must be submitted to Medavie Blue Cross within six months of the date of service provision.
All claims should contain the following information:
- Client information – client name, date of birth and eight-digit client ID number (found on IFHP Certificate of Eligibility or Refugee Protection Claimant Document)
- Provider information – provider name, specialty (if applicable), name of referring prescriber (if specialist is claiming the fee), provider number, address, telephone number and fax number
- Claim information – invoice number (if applicable), date of service, fee code or service provided, ICD-10-CA1 code (can be found at bit.do/ICDcodes – this does not apply to dentists, pharmacists and certain specialties), amount claimed, and prior approval (if required – see “Preauthorization/Prior Approval” section below)
Submitting Claims Electronically:
The Provider Web Portal (www.medavie.bluecross.ca/elogin) allows providers to bill electronically for services covered under IFHP.
Refer to the Medavie Blue Cross Secure Provider Web Portal and Electronic Claims Submission Service guide (http://bit.do/bluecross-login) for step-by-step instructions and screenshots on how to navigate the Portal and submit a claim.
Electronic claims must be submitted within six months (180 days) of date of service.
Submitting Paper Claims:
Paper claims can be submitted by:
- Fax to 506-867-3841 or
- Mail to “Interim Federal Health Program,” Medavie Blue Cross, 644 Main St. PO Box 6000, Moncton, NB EIC 0P9
- Paper claim forms can be downloaded from the Provider Web Portal (https://secure.medavie.bluecross.ca/eai/login) or by faxing a request to Medavie Blue Cross.
Note: Both provider and client signatures are required to make a paper claim.
All paper claims must be submitted within 6 months (180 days) of date of service.
Certain supplemental services and medications require prior approval.
To identify if a service requires prior approval, consult the IFHP Benefit Grids available on the Provider Web Portal (https://secure.medavie.bluecross.ca/eai/login).
This service is available to all provider types, including pharmacies and dental providers.
Preauthorization requests can be sent through the Provider Web Portal, or by telephone or fax.
For detailed information on how to obtain prior approval, see page 16 of the Blue Cross Information Handbook (www.bit.do/bluecrossifhphandbook).
If information on a claim is incorrect, call 1-888-614-1880 or email CIC_Inquiry@medavie.bluecross.ca. Ensure you have the Provider Number, date of service, Client ID number and client name ready.
Allow two business days for reversals/voids/adjustments to be processed.
Payments for services covered under IFHP are made within 30 business days of receipt of the claim submission. Cheques and electronic fund transfers are issued together with a Provider Payment Summary every second week.
Providers may wish to examine and verify the accuracy of the payment summary upon receipt. Medavie Blue Cross requires notification of any errors or omissions within 30 days.
To apply for direct deposit, download an application form from the Medavie Provider Portal website (https://secure.medavie.bluecross.ca/eai/login).