Blue Cross Pt2

General

100

Stacey is calling to inquire about automatic withdrawal set up for her ngbx who do we transfer her to?

NGBX Billing 

• - Calls regarding payments, outstanding balance or reinstatements transfer or provide the number to Alberta Blue Cross billing department at 780-498-5970 or toll free 1-888-498-5970 (Alberta Blue Cross billing department contacts an Alberta Health business specialist for approval when client is requesting a Non Group Blue Cross reinstatement).

200

Stan wants to know if his specific medication is covered under is Seniors BX?

Look on the IDBL or refer to Blue Cross 

300

Larry is using his expired ID to validate his age for seniors bx is this acceptable? 

Yes 

400

Ted is calling to inquire why his NGBX bill is so high he applied for him self only.

Family rate

500

How can i apply for NGBX?

find the application online/registry and apply either in person/mail or fax

Seniors

100

Rebecca's 65th bday is on 20250401 when does her Seniors BX begin?

20250401

200

Ted arrived from Texas to AB on 20250214 and is 66 yrs old he is applying on 20250221 when does his AHCIP and Seniors BX commence?

20250214 AHCIP

202503-Seniors BX

300

Samantha is calling to inquire about her Seniors BX she went to AMA and submitted her proof of age months ago but she went to the pharmacy and they could not bill, you see her ABDL on SSDIR can you move forward?

Yes, Validate her age it will be in effect possibly 24 hrs later

400

Eugenia is calling to inquire if a walker and hearing aids are covered by Seniors BX?

No, AADL

500

Ken wants to know if he can get a drivers medical exam covered under his AHCIP?

no, they are no longer covered but if he is a senior he can take his receipt in to a registry office for 25% back

NGBX

100

David is applying for NGBX, as long time resident he applied on 20250410 and we rec'd his application on 20250420 when does coverage commence?

202508

200

Barb arrived to AB from Australia on 20250710 and is applying for AHCIP and NGBX on 20250808 when does coverage commence?

20250710

202510

300

Brad recently turned 21 and is calling to inquire about why his NGBX is not working. Why would this be? and What does he need to do?

Moved from family acct to his own we need an application sent in for himself to pay a single rate within 30 days.

400

Veronica was recently released from the Canadian Armed Forces in AB on 20250210, she is applying for AHCIP and NGBX on 20250331 when does coverage commence?

20250210

202507

500

Jasmine is calling to inquire about her application for NGBX, you see her application her previous private insurance ended on 20250131 but her application was rec'd on 20250401 what will the start date be?

202508

NGBX

100

Danielle is calling regarding her NGBX it wont work at the pharmacy, upon looking at her acct you see she was recently divorced and placed on her single acct how do we move forward?

In the case where the Stat 1 and 2 are separating and Stat 2 is moving to their old account or a new one, check SSDIR to see who applied for the Non-group. If the Stat 2 applied for it, then we have an application on file and they can have Non-group added to new (or old) account. Because the invoices are sent to the Stat 1, that person will need to notify us if they no longer need it.

In the case where the Stat 2 did not sign the application, then we need them to complete an application within 30 days to have the coverage added so it’s continuous.

200

Tanya is applying for NGBX her previous private insurance cancelled on 20250228 we rec'd her application on 20250320 when does coverage commence?

202503

300

Helen is calling to cancel her NGBX we rec'd her request on 20250710 when is cancellation occur?

202507

400

Jack is calling to cancel his NGBX he is calling on 20250310 he is requesting to back date his cancellation for 202512 since he has work insurance those months can we accommodate his request?

If an account holder requests retroactive cancellation of their Non-Group coverage due to having duplicate coverage:

o advise the account holder that proof of duplicate coverage must be submitted to Health

o Health will check with Alberta Blue Cross to confirm no claims were paid through the Non-Group coverage during the time of duplicate coverage

o if no claims were paid during the duplicate coverage period, the coverage is cancelled retroactively to the same date the duplicate supplementary coverage started, to a maximum of 12 months from the date of notice;

o if claims were paid during the duplicate coverage period, the coverage is cancelled the end of the month in which the last claim was paid, to a maximum of 12 months from the date of notice

500

Daniel should have never had NGBX on his acct (clerical error) it began 202503 when is cancellation?

202502

General/Palliative

100

Where can one inquire about the High Cost Drug Program?

• doesn’t require non group BX to be eligible and it is taken care of through our Health pharmacy department at 780-427-2653

200

Fred is calling and is very concerned that his new med is not covered under the IDBL, he wants to know why and maybe will it be in the future? Who do we refer him to?

• Transfer to the Alberta Health pharmacy department at 780-427-2653

300

Cecilia is calling regarding her patients Palliative BX application can we help her?

WHO CAN ACCESS THE FILE

Note: We can only provide the effective date of the Palliative coverage. NOTHING ELSE

(Contact BS to check the effective date)

 

• If they are part of the Palliative Team (they must verify the account)
• If they are part of the account / family file
• Social worker from AHS (they must verify the account)
• If they can send a Consent form/ POA (Has to mail it to us)
• If it says on the Note on file that they are authorize
• If the account holder can still talk and verified the account and authorize another person who is with him on the phone

400

Mike is a senior and has recently applied for Palliative BX will he receive a new card? 

No, he will continue to use the same card his GRP 66 card

500

Who and when determines the start date for Palliative BX?

• The physician or nurse will determine the effective date
• The date must it be more than 30 days prior to the date Alberta Health received the application
• The coverage will continue as long as the patient is diagnosed as being palliative