Get General Claim Submission Form - Utgsu.ca

Submitting a claim through the General Claim Submission Form for Drug and Extended Health claims can be straightforward and efficient. This guide provides clear, step-by-step instructions to help you successfully complete the form online.

Follow the steps to complete your claim submission with ease.

1. Click ‘Get Form’ button to retrieve the General Claim Submission Form and open it in your preferred document editor.
2. Fill out Section 1 - Plan member information. This includes your Green Shield Canada ID number, surname, first name, address, email address, phone number, and company name, ensuring all details are accurate.
3. Proceed to Section 2 - Mandatory declaration. Answer the questions about any other group insurance coverage you may have, indicating if the coverage is with Green Shield Canada. Specify if you wish to coordinate this claim with other coverage or a Health Care Spending Account.
4. For claims due to an accident or work-related injury, answer the questions accordingly and provide relevant dates and case numbers where applicable.
5. If you are filing a prescription drug claim, be sure to attach official pharmacy receipts containing your name and the details of the drug dispensed. Remember that cash register receipts are not sufficient.
6. In Section 3 - Authorization, sign and date the form. By signing, you authorize the disclosure of information regarding yourself and any dependents for claims processing and confirm the accuracy of the information provided.
7. Finally, in Section 4 - Mailing instructions, ensure you enclose all required documentation with your claim form and understand the submission deadlines. Save changes, download, print, or share the form as necessary.

Complete your GENERAL CLAIM SUBMISSION FORM online today to facilitate your health claim process.