Administrative
1. Why can’t I register for eProfile™ access?
2. Why didn't I receive the email with my Password after creating a logon ID?
3. What is my Certificate Number?
4. I am having trouble and cannot find the help I need to resolve the issue.
5. How do I close one of my eProfile™ accounts if I have more than one?
My Account
6. Why is my eProfile™ account locked?
7. Why is my eProfile™ account expired?
8. Why is my eProfile™ Username or Password invalid? 9. What is eProfile™ Mobile?
10. What is my ‘Wellness Profile’?
11. What are ‘ecards’?
Reimbursement Claims Payment
12. Where do I mail my claims for payment?
13. Can I email/fax a copy of my claim?
14. Has my claim been processed?
15. Why was my claim denied?
16. Has my cheque been issued?
17. Why can’t I see all the claims that I have just been paid for?
eProfile Claims (Coming soon, to be announced on our Home Page)
18. What kind of claims can I submit online?
19. What do I need to submit my claim online?
20. What do I need to know about audits?
Direct Deposit
21. What is direct deposit?
22. How do I sign up for direct deposit?
23. I
have enrolled in direct deposit. I no longer want direct deposit
payments and would like to have my claims paid by cheque instead. How
can I do this?
24. How do I know if my claim was paid by direct deposit?
25. How much was deposited to my bank account?
26. How do I change my personal direct deposit and banking information that is currently on file?
27. Can someone else change my direct deposit banking information?
28. I
received an email indicating that the direct deposit payment was
unsuccessful. Why was the payment unsuccessful? What do I have to do to
correct the issue and obtain payment?
29. The eProfile™ payment detail screen says that the direct deposit payment has been sent. What does 'sent' mean?
30. The eProfile™ payment details screen says that the payment status has failed. What does 'failed' mean?
31. I
entered my direct deposit banking information and signed up for direct
deposit. However, I received a payment by cheque. Why did this happen?
32. I can see on your website that direct deposit payment is an option but I cannot enroll. Why not?
33. I can see a direct deposit in my bank account but I did not receive an email notifying me of the deposit. Why?
1. Why can’t I register for eProfile™ access?
- If your coverage is terminated, you are not eligible for eProfile™ access.
- If you are a dependant under the age of 16 yrs you are not eligible for eProfile™ access.
- The
information that you entered does not match the data on our system, eg.
Group Number, Certificate Number, last name, first name and/or date of
birth.
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2. Why didn't I receive the email with my Password after creating a logon ID?If you use a web-based email provider (e.g. Hotmail) and your email account is full or inactive, you will not receive email.
Or
If
you have a junk mail filter or spam blockers in your email set up, you
may not receive your email. The subject of the email is " eProfile™
account information"
Or
You may have entered an incorrect email address during registration. Please follow these steps:
a) Try to sign in again and wait for the link that says ‘Click NEXT to unlock your account’
b)
Click on the link and re-enter your personal information (Username,
Group Number, Certificate Number, date of birth, email address and
answer to the secret question)
At this point you will receive an email showing your Username and a new system generated Password.
Or
If you have forgotten your Username then:
You
must register again. You may have more than one Username registered;
however each Username must be unique. Your Passwords do not have to be
unique so you may reuse the Password that you used with the first
Username.
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3. What is my Certificate Number?Your Certificate Number is
shown on the front of the ClaimSecure health benefit card. Members of
groups that do not receive ClaimSecure health benefit cards may not know
their Certificate Number and will have to call their benefit plan
administrator to obtain it. These groups include student groups using
student id’s that have an alpha character at the start of their
Certificate Number, as well as any other group without cards.
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4. I am having a technical or IT problem and cannot find the help I need to resolve the issue.
Please contact the ClaimSecure helpdesk:
Phone: 705-669-2621
Toll Free: 1-888-513-4464 ext. 2621
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5. How do I close one of my eProfile™ accounts if I have more than one?Please contact our Customer Response Centre at 1-888-513-4464 and we will assist you with this issue.
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6. Why is my eProfile™ account locked?Your account is locked
because you tried to sign on unsuccessfully more than five consecutive
times. The purpose of this lock is to maintain effective security in
order to ensure that your personal information is kept secure and
private. In order to unlock your account you must follow these steps:
If you remember your Username then:
a) Try to sign in again and wait for the link that says ‘Click NEXT to unlock your account’
b)
Click on the link and re-enter your personal information (Username,
Group Number, Certificate Number, date of birth, email address and
answer to the secret question)
At this point you will receive an automated email showing your Username and a new system generated Password.
Or
If
you have forgotten your Username then you must register again. You may
have more than one Username registered; however, each Username must be
unique. Your Password does not have to be unique so you may reuse the
Password that you used with the first Username.
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7. Why is my eProfile™ account expired?You must sign on with
your new Username and Password within 14 days of receiving it. If you
do not do so, the logon will expire and you will need to register again.
You may have more than one Username registered; however, each Username
must be unique. The Password does not have to be unique.
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8. Why is my eProfile™ Username or Password invalid?Please
check your email for the Password assigned to you when you first
registered. Some of the common reasons for this problem are listed
below.
a) If there is the letter L or the number 1 in the
Password, verify that you did not misinterpret the Password, e.g. a
lower case L may look like the number 1 (or vice versa).
b) The Password is case sensitive, e.g. If the Password is "Happy", you cannot enter "happy".
c) The Username for the Sign In screen is not case sensitive, e.g. JohnDoe, JohnDOE, and johndoe are all valid entries.
Or
If
the above is not successful, register for a new Password. On the Sign
In screen, go to the "Forgot your Password" link to get a new Password.
You will receive an email with your new Password within 30 minutes.
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9. What is eProfile™ Mobile?eProfile™ Mobile is technology
that enables users the ability to access eProfile™ services from the
convenience of their Smartphone. Visit
www.claimsecure.com to download the eProfile™ App today.
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10. What is my ‘Wellness Profile’?The Wellness Profile is
your on-line personal health profile that will enable you to better
manage or understand your overall health. By completing and maintaining
your profile, you will be emailed educational material, coupons and
other promotional offers related to your specific health areas of
interest.
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11. What are ‘eCards’?An eCard is an electronic health card
that is accessible from your Smartphone. The eCard is an extension or
replacement of a traditional plastic card. Access your eCard from your
eProfile™ account and simply present your Smartphone, with your eCard
clearly displayed, at point of sale. The pharmacist, dentist or other
healthcare practitioner will record your unique card information and
transmit the claim to us using the same process.
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12. Where do I mail my claims for payment?All claims are to be mailed to:
ClaimSecure Inc.
P.O. Box 6500 Station A
Sudbury, ON
P3A 5N5
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13. Can I email/fax a copy of my claim?For the purposes of verification and auditing, original claim forms and receipts must be mailed to ClaimSecure.
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14. Has my claim been processed?Please visit the "Online
Services" section located in the left hand corner of our Home Page and
click "Member" to access up-to-date claims information via the
Internet. Your online claims information will indicate if a claim has
been processed. If you are visiting the site for the first time, you
will be required to click "Register Now" prior to obtaining a Username
and Password to access your personal claims information.
Or
Contact
our Customer Response Centre at 1-888-513-4464 from 7:00 a.m. to 11:00 p.m. EST,
Monday through Friday. To ensure prompt service, please have your
Certificate Number and Group Number on hand.
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15. Why was my claim denied?Your claim may be denied for a
number of reasons, which are generally outlined on your Explanation of
Benefits. Please visit the "Online Services" section located in the left
hand corner of our Home Page and click "Member" to access up to date
claims information via the Internet. Your online claims information
includes an explanation as to why a claim has been denied. If you are visiting
the site for the first time, you will be required to "Register Now"
prior to obtaining a Username and Password to access your personal
claims information.
Or
If you require further detail,
please call our Customer Response Centre at 1-888-513-4464 from 7:00 a.m. to
11:00 p.m. EST, Monday through Friday. To ensure prompt service, please have
your Certificate Number and Group Number on hand.
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16. Has my cheque been issued?To access up to date claims information login to your
eProfile™ account. Your online claims information includes payment details. If you are
visiting the site for the first time, you will be required to "Register
Now" prior to obtaining a Username and Password to access your personal
claims information.
Cheques are issued and mailed to plan
members on a daily basis. Claims are processed and correspondence issued
within five business days of receipt by ClaimSecure.
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17. Why can’t I see all the claims that I have just been paid for?You
can view claims for yourself or any dependents. For privacy reasons
your spouse or any dependents over the age of sixteen, may open their
own eProfile account to be able to view their health benefit claim
details.
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18. What kind of claims can I submit onlineYou can submit the following claim types for real-time adjudication:
- Drug
- Vision
- Massage therapist
- Chiropractor
- Physiotherapist
- Acupuncturist
- Chiropodist/Podiatrist
- Naturopath
- Osteopath
- Psychologist
- Speech therapist
- Dental (without lab fees)
- HSSA Claims
You
can also submit the following claim types for non real-time
adjudication (these claims will be reviewed and processed manually by
our adjudicators):
- Hearing aids
- Hospital
- Wellness
- Transport
- Nursing
- Appliances
- All other paramedical
- X-Rays
Note that eClaims are subject to random audits. See ‘What do I need to know about audits’.
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19. What do I need to submit my claim onlineYou need to have a
ClaimSecure eProfile account and have enrolled in direct deposit. Your
online claims submission privileges must be in good standing.
Additionally, you will need your paper claim receipt. You must keep all
receipts and supporting documentation for the 12 months following claim
submission.
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20. What do I need to know about auditsClaims submitted by
you online are subject to random audits. You will be notified at the end
of submitting a claim whether your claim has been selected for audit
and will be presented with details. You must submit your paper claim and
any supporting documentation within 30 calendar days to ClaimSecure.
Please note that failure to comply may result in suspension of your
online claims submission privileges.
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21. What is direct deposit?This is a secure method of
electronically transferring health benefit claim payments directly into
your bank account, instead of paying these claims by cheque.
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22. How do I sign up for direct deposit?If you currently
have an eProfile™ account, log on with your Username and Password and
access the screen Direct Deposit which is located in eProfile™ Main
Menu. If you are not yet registered for eProfile™, please access our
eProfile™ Registration Screen and follow the instructions to apply for
online access to your account and direct deposit enrollment.
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23. I have enrolled in direct deposit. I no longer want direct
deposit payments and would like to have my claims paid by cheque
instead. How can I do this?Please log on to your eProfile™
account, access the Direct Deposit screen, and change your payment
preference from direct deposit to cheque. You will be asked to confirm
this change before it is processed. Please note that once a payment
is processed as a direct deposit payment, this payment cannot
subsequently be changed to a cheque payment. Therefore, any claims that
have been processed prior to you changing the payment method from direct
deposit to cheque will be paid by direct deposit. All future claims
will be paid by cheque.
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24. How do I know if my claim was paid by direct deposit?When
a direct deposit benefit claim payment is made, you will receive an
email message at the email address listed in your eProfile™ account,
indicating that a direct deposit payment has been submitted to your bank
for deposit to your bank account. To verify your payment details, log on to your eProfile™ account to view the payment details. If
a direct deposit health benefit claim payment cannot be processed by
your bank, you will receive an email message at the email address listed
in your eProfile™ account. Please note that it can take several days for your bank to confirm the acceptance or rejection of a direct deposit payment.
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25. How much was deposited to my bank account?To verify your payment details, log on to your eProfile™ account to view your claim payment details.
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26. How do I change my personal direct deposit and banking information that is currently on file?You
can change your direct deposit and banking information by logging on to
your eProfile™ account and following the instructions on the Direct
Deposit screen.
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27. Can someone else change my direct deposit banking information?No.
Your direct deposit banking information is maintained in your secure
eProfile™ account. No one but you can access or change your eProfile™
account or your direct deposit banking information. To verify or modify your direct deposit banking information, please log on to your eProfile™ account.
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28. I received an email indicating that the direct deposit payment
was unsuccessful. Why was the payment unsuccessful? What do I have to do
to correct the issue and obtain payment?To ensure you receive your payment, please follow these instructions:
a) Review the email to determine the reason(s) why your direct deposit payment was unsuccessful.
b)
Log on to your eProfile™ account and verify your banking information by
accessing the Direct Deposit screen. The eProfile™ banking information
includes your bank name, transit number and account number. You can find
a sample cheque that outlines the format of the required banking
information in the Help screen.
c) Correct your banking information and click “Submit” to accept the change(s) that you have made.
Once
you have corrected your eProfile™ banking information, we will
automatically reattempt a direct deposit payment transfer to you on the
following business day. Please note that you do not need to inform us of
the change. You will be notified by email that we have reattempted the
payment transaction.
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29. The eProfile™ payment detail screen says that the direct deposit payment has been sent. What does ‘sent’ mean?A
sent payment is a payment that has been submitted to your bank by
ClaimSecure for deposit. This payment may not yet have been accepted at
your bank.
Please note that it can take several days for your bank to confirm the acceptance or rejection of a direct deposit payment.
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30. The eProfile™ payment detail screen says that the payment status has failed. What does ‘failed’ mean?A
failed payment indicates that the direct deposit payment could not be
completed by your bank. In this case, we will email a notification to
your email address listed in your eProfile™ account.
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31. I entered my direct deposit banking information and signed up
for direct deposit. However, I received a payment by cheque. Why did
this happen?There are two possible reasons:
1) The health
benefit claim may have been processed prior to the time that your direct
deposit enrollment became effective. All future claims will be paid by
direct deposit.
2) You may have created more than one eProfile™
account. Direct deposit banking information is determined based on the
data in the eProfile™ account that was most recently created. Please
ensure that your most current eProfile™ account has been updated with
your direct deposit banking information.
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32. I can see on your website that direct deposit payment is an option but I cannot enroll. Why not?There are two possible reasons:
1)
Only health benefit plan members are eligible to enroll in the direct
deposit program. Payment is only issued to the plan member.
2) Your group is not eligible for direct deposit payments. Please contact your benefit plan administrator for clarification.
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33. I can see a direct deposit in my bank account; however, I did not receive an email notifying me of the deposit. Why? You may not have received an email for one of the following reasons:
1) Your email address in your eProfile™ account may be incorrect; or
2) Your Internet Service Provider may have blocked the email for some reason.
We
recommend that you log on to your eProfile™ account and verify that
your email address is correct. If it is correct, then you should contact
your Internet Service Provider for further assistance.
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