For audio claims reimbursement, send a completed claim form and itemized paid receipts showing:
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Patient name, address and GSC ID number
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Audiologist name and address
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Date and service received
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Copy of audiogram
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Breakdown of charges (i.e. acquisition cost, fee, mold)
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Details of provincial funding, if applicable
Send to:
Green Shield Canada
Audio Claims
P.O. Box 1623
Windsor, Ontario
N9A 7B3
For dental predeterminations, forward:
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Treatment plan estimate completed by your dentist
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X-rays (your dentist can submit these online via providerconnect.ca so be sure to ask)
For dental claims reimbursement, forward a dental claim form, completed by both the plan member and the dentist. If your claim is a result of an accident, a Dental Accident Report Form and your dental x-rays must be submitted to GSC for prior approval. Failure to comply may result in non-payment.
Send to:
Green Shield Canada
Dental Claims
P.O. Box 1608
Windsor, Ontario N9A 7G1
For a pre-authorization, forward a pre-authorization form and a doctor’s prescription indicating the diagnosis and what is prescribed.
For claim reimbursement, forward an original itemized paid receipt and claim form, including:
- Patient’s name, address and GSC ID number
- Provider’s name and address
- Date and charges for each service
- A detailed description of the equipment
Send to:
Green Shield Canada
Durable Medical Equipment/Medical Items
P.O. Box 1623
Windsor, Ontario
N9A 7B3
GSC must be contacted by phone within 48 hours of commencement of treatment. Please call our Customer Service Centre at 1.888.711.1119 for detailed claims submission instructions.
For claims reimbursement forward an original itemized paid receipt and claim form, including:
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Patient name, address and GSC ID number
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Provider’s name and address
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Date and charges for each service or supply
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A detailed description of the service or supply
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Medical referral when required (your benefit plan documentation will
tell you if you need a referral, like a physician’s prescription)
Send to:
Green Shield Canada
General Health Claims
P.O. Box 1606
Windsor, Ontario N9A 6W1
For HCSA claims reimbursement, forward an original itemized paid receipt and claim form, including:
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Patient’s name, address and GSC ID number
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Provider’s name and address
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Date and charges for each service or supply
Send to:
Green Shield Canada
HCSA Claims
P.O. Box 1606
Windsor, Ontario N9A 6W1
For hospital accommodation claims reimbursement, forward a claim form and an original itemized paid receipt including:
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Patient’s name, address and GSC ID number
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Admission and discharge dates
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Daily semi-private accommodation charges
Send to:
Green Shield Canada
Hospital Claims
P.O. Box 1615
Windsor, Ontario N9A 7J3
For claims reimbursement, forward a claim form for related health professional services and an original itemized paid receipt including:
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Patient’s name, address and GSC ID number
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Provider’s name and address
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Date and nature of treatment
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Charges for each service
Send to:
Green Shield Canada
Professional Services
P.O. Box 1699
Windsor, Ontario N9A 7G6
For prescription drug claims reimbursement, forward all itemized prescription drug receipts from your pharmacist (cash receipts or credit card receipts alone are not acceptable) and a claim form, together with the patient’s name, address and GSC ID number.
Send to:
Green Shield Canada
Drug Claims
P.O. Box 1652
Windsor, Ontario N9A 7G5
Pre-authorization is required from GSC prior to commencement of services. Please call our Customer Service Centre at 1.888.711.1119 for detailed instructions.
For vision claims reimbursement, forward a vision claim form completed and signed by the optical provider and an original itemized paid receipt including:
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Patient’s name, address and GSC ID number
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Provider’s name and address
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Date of service (the date glasses or contacts are picked up)
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Vision prescription
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Breakdown of charges for lenses and frames (if applicable)
Send to:
Green Shield Canada
Vision Claims
P.O. Box 1615
Windsor, Ontario N9A 7J3