The
First Nations Health Authority (FNHA) has transitioned the administration of
its medical supplies and equipment (MS&E) benefits to BC-based benefits
provider, Pacific Blue Cross (PBC).
What’s New?
Submit
all new MS&E claims and pre-determinations (PDs) for FNHA clients to PBC
using the policy number 40000. Member ID numbers will be the same as clients’
Status Numbers.
MS&E
Plan Highlights
No PDs are required
for the following MS&E items:
- Crutches
- Pressure garments
- Walkers
- Walker repairs
Other
MS&E items not listed above may still require PDs. PBC will accept paper PD
forms submitted by mail (PO Box 7000, Vancouver, BC V6B 4E1) or fax (for FNHA
clients only: 604-677-0277).
Please
support FNHA clients in obtaining all the required documentation, which may
include prescriptions, medical documentation and a completed and signed PD
form.
What do I need to
do?
Review
Resources
FNHA
and PBC have posted resources on their websites. Please review the following
documents to find further information about how to check eligibility and find
details about the FNHA MS&E benefits plan:
- PBC Medical Supplies & Equipment Provider Reference Guide
- Medical Supplies & Equipment Fee Supplement for Clients of the FNHA
Is FNHA still the
last payer (coordination of benefits)?
Yes,
the FNHA MS&E benefits plan administered by PBC will remain the last payer.
If an FNHA client has access to another public (e.g., provincial) or private
benefit plan, their claims must be submitted first to that plan for coverage.
If the fees are above the maximum limit of the benefit coverage, please inform
clients of the out-of-pocket costs in advance.
What number do I
call?
If
you need assistance, please call PBC at 604-419-2000 or toll-free at 1
877-PAC-BLUE (1-877-722-2583). For questions about the Reference Guide and Fee
Supplements and how to log in to PROVIDERnet, visit pac.bluecross.ca/provider.
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