Coverage
125% the OHIP rate
How much are physician services covered up to?
clients.cowangroup.ca, uhip.ramu@cowangroup.ca, fax:613-741-7771, or mail 700-1420 Blair Towers Place
How can I submit a claim?
A physician's referral (recommendation) & an estimate including a breakdown of the costs and the associated provincial procedure codes.
What is required for pre-approval?
Case Management case.mgmt@cowangroup.ca
Who approves treatments/procedures that are not medically necessary?
This is where you should advise members to find a provider
what is Uhip Preferred provider network?
Drugs, dental, glasses, massage
What are examples of services NOT covered by UHIP? *refer to university for these benefits*
These are the only providers who currently have access to the provider portal
Who are campus providers?
corrective or reconstructive jaw surgery that can only be performed in hospital (covered at 100% of what the provider charges for Ontario residents to the same overall maximum and terms as under OHIP), when pre-approved by Cowan.
What is oral and maxillofacial surgery?
This is who can make changes to the members name or DOB
Who is the UPA?
This is where you should direct members for inquiries on coverage details
This is covered to the same overall maximum and terms as Assistive devices program, when pre-approved
What are assistive medical devices such as mobility aids, diabetic supplies and respiratory equipment?
This is where we send documents to be scanned into Laserfiche
What is ottawa.mailroom@cowangroup.ca?
The services to transport to your home country once you are stable, when Cowan pre-approves and arranges these services
What is repatriation?
This is how you update the member's address
What is Class under Update?
This is where you should advise members check their explanation of benefits
Limited to emergencies only, meaning your condition requires immediate medical attention to relieve acute pain and suffering.
What is out of province coverage?
or out of country to a max of $50/day for outpatient, $400/day for ICU or $200/day lower level inpatient
Service date, description of service, provincial procedure codes, diagnosis/reason, cost of service and either proof of payment or signed assignment of benefits (claim form section 3A&B).
What is required when submitting a claim?
Once every 12 months if pre-approved with a diagnosis of one of the following:
When would an eye exam be considered for approval for a member ages 20-64?
Full name (matching CLASS), certificate number, DOB, university e-mail address.
What are the required credentials for registering on our member portal/downloading e-Card?
This is where providers can find everything they need to know about billing for UHIP members
what is https://uhip.ca/for-medical-professionals-and-billing-agencies-only/?
*upper right side, "info for medical professionals"
Within Ontario to the nearest available hospital in the province, when confirmed as essential by physician or hospital official (covered at 100% of the OHIP rate, less the same $45 fee)
What is ambulance coverage?
Takes up to 5-10 business days
What is how long it takes for a claim to be processed?
This type of service would be considered for coverage approval for a member aged 20-64 only if it is required due to a complex injury that required at least an overnight hospitalization
What is physiotherapy? (up to an overall maximum of $312)
This is who determines the members eligibility
Who is the UPA?
This is where we should advise members and providers to download a claim form with instructions
What is https://uhip.ca/submit-a-claim/?