There are different rules for billing and claiming health services for different people in Canada. The ACAO has contracts with several health service programs to make it easier for some groups to claim their eye care costs.
The ACAO has contracts with Alberta Blue Cross to provide health services to various groups of people.
The Alberta Blue Cross website has a list of groups that receive health benefits. It also has instructions on the billing time-frame.
Many of the groups that receive health benefits from the Government of Canada partner with Medavie Blue Cross to provide a direct billing option.
Balancing financial obligations with financial relief
As much as we would love for every optician to be in a position to offer these services at every location, the reality is that sometimes it’s not possible. We know that it can be especially hard for smaller businesses and independent stores to make ends meet when the contract doesn’t cover the extra expense on some jobs.
While we encourage you to participate in these programs, if you find that you need to opt out, you should inform the contractor in writing that you will be unable to participate in ANY part of the contract; this is in the interest of fairness. You can’t agree to do the simpler jobs and refuse the harder, more expensive ones, because it is inequitable to those patients who require extra care.
You may also discuss these issues with the negotiations committee chair. The negotiations committee chair works with the contracts and points out any issue of disparity to the payers.
We hope that future contracts will be able to cover the full cost of everything their patients need. In the meantime, we encourage you to participate, if possible, for the sake of those who rely on these programs to receive proper care.
The Alberta Human Services Contract and Fee Schedule is effective July 1st, 2020. This contract covers “Independence, AISH, Children’s Services and Child Health Benefits.”
Health services for our nation’s first peoples
The Non-Insured Health Benefits (NIHB) program provides eligible First Nations and Inuit clients with coverage for a range of health benefits that are not covered through other social programs, private insurance plans, or provincial or territorial health insurance.
For more information about the Non-Insured Health Benefits program, visit the First Nations and Inuit Health Branch page on the Health Canada website. To view the NIHB Vision Care Provider Agreement, click here.
For NIHB health provider information including provider registration and claim processing procedures, visit the Health Provider Information page. The procedures for submitting an NIHB claim are outlined on the Express Scripts Canada Non-Insured Health Benefits Claims Services Provider Web site (www.provider.esicanada.ca). The site also contains claim forms, newsletters, fee schedules and much more.
For NIHB contact information, click here.
For those who served our country
The Veterans affairs website says: “For most benefits, your provider will need your signature to confirm that you received their services. It is important that you only sign after you have received the service.” Veterans should have their VAC health card with them.
For those who continue to serve
The national health benefits plan covers public service pensioners, too. So, some retired RCMP officers and their families may also qualify.
For those new to our country
The IFHP website recommends that before providing services, you verify that your patient is covered every time you see them. The IFHP is a temporary program, and a patient may no longer be eligible since their last visit. You will not be able to bill for any services provided for those no longer covered under the IFHP.