TELUS Health Solutions currently offers electronic claims transmission from health care providers to workers' compensation boards, for adjudication. Over 3,600 providers are registered with our provider registry service. We will be extending this feature to enable more health care providers to electronically submit claims to Group insurance customers as well as workers compensation boards. Learn more about our Assure Claims Network.

An integral part of TELUS Health Solutions' multi-benefit claims management solution

We will soon be implementing a complete Extended Health claim management solution that utilizes many of the newer features that have made our Assure Claims Drug solution so successful. By creating a common platform for managing all benefits, we provide additional flexibility and process efficiencies to insurance customers. Our Assure Claims Extended Health solution will support auto and manual adjudication of claims, integrating the quality and anti-fraud controls our customers expect. Our Assure Claims Extended Health features simple, straightforward claim input

Integration with health professionals' practice management software

We will be offering our Extended Health Claims provider interface to existing practice management software vendors, thereby streamlining the claims submission procedure and eliminating the need to duplicate data entry.

Outsourcing paper claims

This solution is fast, reliable and user-friendly. As an integral part of our core Extended Health Claims solution, it improves productivity and reduces processing time. We also offer clients the option of outsourcing some or all of their paper claims. Claims are entered on our screens and are then forwarded to the client's adjudication engine via our network or are adjudicated directly via our adjudication engine. Clients who chose to adjudicate their own claims will receive electronically paper claims that have been converted to an electronic format by us, in the same way they receive dental EDI claims.

Flexible, thorough management features

Assure Claims Extended Health plan management and plan assignment modules will offer detailed, flexible plans designed to handle plan sponsor needs, including cross-benefit plan design. Our benefit specialists work with our clients to ensure their plan designs reflect their customers' requirements.

Seamless transition of administration data

Most insurers store group and member information on their own administration systems. We develop mutually compatible interfaces to allow efficient, secure transfer of this data to our system in order to validate eligibility requirements.

Total access to fee information

Our service code management feature stores every carrier's own reasonable and customary tables by benefit type, province, age and any other parameter selected by our customers. Tables can be managed via our user-friendly Web interface. Customers can also choose to outsource this function to us.

Simple management of provider information

TELUS Health Solutions' central provider registry stores all provider-related information required to validate submissions and assign payments via our electronic file transfer. Managing this function centrally on behalf of all our clients enables consistent and fair treatment to all providers submitting health claims and saves individual carriers time and money.

Remote access to our management interface

Carriers can access our user-friendly web interface to view all aspects of our Assure Claims Extended Health solution from one consolidated set of screens.

Complete set of reporting tools

We have developed a web-based module allowing insurers to execute requests for every aspect of claims management, from claims status and history to parameters on a plan sponsor's benefit plan. We also provides data extraction tools to support our customers' internal processes and applications.

Efficient adjudication process

Real-time adjudication

Extended healthcare providers can submit claims with our user-friendly interface or soon via practice management software that's connected directly to our adjudication engine, and receive a response in real time.

Customizable auto-adjudication parameters

Our adjudication engine allows us to easily customize rules norms and parameters at the insurer and plan level. We continuously studies payment patterns to refine rules and maximize accurate auto-adjudication potential and has developed a complete expert system to optimize this critical process.

TELUS Health Solutions' claim manager feature is an advanced workflow system that efficiently queues pended claims to the resource identified as having the appropriate skills to expedite. This queuing system enables department managers to track workflow effectiveness and balance examiners workload.