HOW TO MAKE A BENEFITS CLAIM: MYGROUPHEALTH

How to Make a Benefits Claim: myGroupHEALTH

Your employer sponsors an employee benefits program to help support you and your health. It’s part of the compensation you receive for the great work that you do! Now the next step is to go out and use your employee benefits to keep yourself healthy and happy. After you’ve used them, it’s time to make a benefits claim. Don’t worry – it’s actually really easy.

Your Benefits Information Is On myGroupHEALTH

For starters, you have access to a great online benefits portal called myGroupHEALTH. You can access it on the web by visiting www.mygrouphealth.ca or you can download the myGroupHEALTH app (from the App Store or Google Play). It’s a really easy and convenient platform for everything related to your benefits. Your username and password can be found in your “welcome” letter or e-mail.

Signing on to myGroupHEALTH gives you access to all your benefits information. You can view the most up-to-date version of your benefits booklet to find out all the specifics of your coverage. Your benefits booklet has all the nitty-gritty details of your employee benefits coverage, so you know exactly what is available to you.

There are other important things you can do on myGroupHEALTH. Ever misplaced your benefits card, then found yourself scrambling to find it when you needed it? If this happens again, you can simply log into myGroupHEALTH and access an electronic version of your benefits card to show your provider. Better still, if you download the myGroupHEALTH app, your benefits card is available on your phone, without even having to sign in.

You can also update your banking information that’s used to direct deposit money into your account when a claim is being paid.

Making A Benefits Claim Using myGroupHEALTH

In the not so distant past, benefits claims had to be mailed in (no, not e-mailed, but snail mail!). It was not uncommon to wait weeks from the time you sent your claim until you received a response in the mail (usually a cheque to cover the cost of your claim).

Luckily, those days really are in the distant past. Now you can submit claims online (in a matter of minutes) and receive payment for covered benefits as quickly as a few days after submitting the claim.

There are 3 options for online claims submission via myGroupHEALTH:

1. Pay Direct – This is the easiest option because you really don’t have to do anything (except show your benefits card to the provider). While you wait, the provider submits the claim on your behalf, and if approved the covered portion of the claim is paid directly to the provider. Pay directly is common for prescription drugs, dental and some medical practitioners. The downside is that not all healthcare providers offer this option.
2. myGroupHEALTH Claims Submission – When Pay Direct is not available, you’ll have to pay out of pocket for your employee benefits expenses, and then be reimbursed. This method requires you to log into your myGroupHEALTH account and click on “Submit Claim.” You’ll be guided through a series of screens where you’ll enter all the required information for your benefits claim. Next, you’ll review the information you have submitted and read through and accept the Claim Consent Authorization. Finally, you’ll upload any required supporting documents (such as a picture of your receipt). Entering all these information speeds up the adjudication process, so your claim will be processed in just one business day!
3. MyGroupHEALTH Photo Claims (aka Quick Submit) – This final method is great if you are in a hurry and don’t want to take the time to enter in all the required information for a regular myGroupHEALTH claims submission. You’ll still start by logging into your myGroupHEALTH account and clicking on “Submit Claim.” Instead of navigating through the screens that gather information on the claim, you simply click on the “Quick Submit” button near the bottom of the page. You’ll be prompted to upload a photo of your receipt, read through and accept the Claim Consent Authorization and you’re all set. The benefit to Quick Submit is you get to skip through entering all your claims information. Just be aware that you may have to wait up to 5 business days for your claim to be processed (because the claims adjudication process will take longer).

Advantages to an online portal

Having access to an online portal like myGroupHEALTH has a lot of advantages. You save time and money (no stamps required!) by having the ability to access everything benefits related to one online location. If you’re wondering about your coverage or the status of your claim, simply log on for the most up-to-date information available to you. It’s meant to be an easy, user-friendly tool to make your benefits experience that much better. After all, your employer really does appreciate all the work that you do.