Steps to making successful medical claims

Claims Services are provided by MSH INTERNATIONAL (Canada) LTD.

Tel +1 (403) 538-2364 or call toll free from Canada or USA to1 (800) 808-2694

Fax (403) 265-9425

1. (As needed) Request Pre-Authorization of medical services from MSH International

To request pre-authorization for a hospital admission, for a specialist consultation, or for a medical procedure, including certain diagnostic tests (such as a CAT scan or MRI) either email precert@msh-intl.com or call MSH International (Canada) Ltd. at 1 (403) 538-2364 or toll free within North America at 1 (800) 808-2694.

You will need to provide MSH the following information:
- your full name as it appears on your insurance ID Card
- your date of birth
- your present location
- the name of the medical facility you are (or will be) for the proposed medical services
- the name and contact information for the attending physician (if known)
- how you can best be contacted for further assistance

If possible, ask your medical clinic or physician to complete the Precertification & Direct Billing Request Form

NOTE If you are admitted to a hospital you must notify MSH Assistance immediately.

Call 1 (800) 808-2694 or email precert@msh-intl.com See the Emergencies page for further direction.

2. Collect and Complete Required Documents

To process a claim the insurance company (MSH INTERNATIONAL) needs:

a fully completed Claim form,

a copy of itemized medical bills and receipts for expenses being claims, and

information about the reason for seeking medical services, the consultation results (diagnosis), and about any further medical services ordered by the attending physician.

It is recommended to bring a Claim form with you at the time of seeking doctor consultation. On page two of the form there is a section called “For Medical Providers Only” where your physician is to indicate if a prescription for medication and/or requisition of diagnostic tests and/or referral to a specialist was made, and add his or her signature.

Whether you are treated at a doctor’s office or at a hospital, be sure to ask the doctor or the clinic staff for a copy of your “health record” (also referred to as a patient chart) for each visit, so that you can include a copy of your health record with your claim form.

The “Medical Services” section of the claim form is where you list each medical service cost included with your claim, and write details about the reason for needing that medical service, and if applicable indicate if you have prior medical history for the condition treated.

Please note: Claims for medical expenses that you have already paid should be submitted separately to claims you want to make for unpaid medical bills that you want the insurance company to pay direct to the medical provider.

Contact MSH INTERNATIONAL if you need help with preparing a claim.

3. Submit Claim

To process a claim MSH INTERNATIONAL will need your completed claim form, along with all related invoices/bills/receipts and treatment statements. (Detailed invoice with diagnostic code or description of treatments, Doctor's Notes, ER Report)

If your claim is under USD $10,000 it may be faxed or emailed to initiate processing, however the original hard copies must be retained by you for a period of 24 months after the claim was incurred. MSH INTERNATIONAL may request copies of the original receipts at any time to validate your reimbursement. If upon request you cannot provide the original copy of claim/receipt documents you may be liable to re-pay your claim reimbursement to MSH INTERNATIONAL.

To process a claim of over USD $10,000 MSH INTERNATIONAL must receive your original claim documents in hard copy.

The deadline for submitting claims is 365 days after the date of the medical expense or 90 days after the end of your insurance policy, whichever is earlier.

Tip! Submit all claims as quickly as possible, and before you mail original documents, make copies for your own records.

Send claim forms, and all pertinent documents to:

MSH INTERNATIONAL (Canada) LTD.
2900, 605 – 5th Avenue S.W.
Calgary, Alberta
T2P 3H5, Canada

Fax (403) 265-9425

Email claimsamerica@msh-intl.com

4. How to track the status of your claims

After MSH International processes your claim, the confidential details about the outcome will be presented in an Explanation of Benefits (EOB) letter. An EOB letter is created for every type of claim outcome which can include notice of a Paid Claim, a Request for More Information, or a Declined Claim. The EOB letter will also indicate the amount of the claim payment, who the claim payment was made out to, and the method of payment. An EOB letter will be issued for claims that you submit yourself, and for claims billed directly to MSH from your medical provider. We recommend monitoring the status of all your claims, including those which were submitted for you by your medical provider.

How to access your Explanation of Benefits (EOB) Letter(s)

MSH does not mail EOB letters in hard copy (except by special request). Instead, MSH will upload an electronic copy of your EOB letter to a confidential online account created for you on the MSH Member Portal. If MSH has your email address on file then they will send you a “Reimbursement Notice” email to prompt you to check your Member Portal for the details about your claim. To access your confidential online account you need to sign up for your Member Portal login. Instructions on how to do that follow below.

5. How to sign up for your MSH Member Portal login

To sign up for your Member Portal account MSH International must have your email address on file, and you must know your personal MSH certificate number. Your personal certificate number (also referred to as a Member ID) is unique to each primary insured person and is not the same as a policy number or group certificate number. For most Global Campus Health Plan – Advantage plan members MSH assigns the personal certificate number at the time of processing your first claim or pre-authorization request.

If you already know your personal certificate number, then follow Step 2 below.

If you do not know your personal certificate number, then follow Step 1 to request it from MSH, and proceed to Step 2 once you know your certificate number.

Step 1

Send an email to claimsamerica@msh-intl.com with "Need Certificate # for GCHP Member Portal Login" in the subject line, and include the following information with your request:

your full name as it appears on your GCHP Card
confirm (or update as needed) the email address you want MSH to register to your Member Portal account.
your insurance policy number (or group certificate number if applicable) from the front of your GCHP Card
your claim/case number (if you have one)

Please allow two business days for MSH to respond to your request. MSH will send you an email with your personal certificate number, and instructions for you to complete your Member Portal login sign-up.

Step 2

A. Go to MSH's Sign Up for Online Access page.

B. Enter the required information: personal certificate number, email address on file, and date of birth

C. Click the "Sign-Up" button and follow prompts to set a username and password for your account.

Once you have created your profile, future log-ins will only require your certificate number and password at the Member Area Login Page.

If after following the steps above you encounter any difficulty with the process of signing up for your Member Portal login then please email clientservice@americas.msh-intl.com.

6. Read & Ask Questions

For a complete understanding of the procedures and conditions that apply to medical claims, read your policy wording, especially the section called "Procedures Applicable to Medical Claims".

Because the policy wording is a legal document some of the language may be difficult to understand. If you have questions, please contact David Cummings Insurance Services Ltd. or MSH International (Canada) Ltd..