Roles and Responsibilities

Veterans Affairs Canada determines client eligibility, eligible benefits and, if necessary, authorizes benefits. Claims for reimbursement of expenses which have been directly paid by clients are also processed by VAC.

Blue Cross registers providers and processes provider claims. If the claims are approved, a cheque and payment summary are sent to the provider. If the claims are rejected, they are returned to the provider with an explanation.

Providers verify clients' eligibility and, when necessary, obtain from VAC the authorization to provide the service or benefit. The benefits are then supplied and claims submitted for payment to Blue Cross or VAC, as appropriate.

The Client presents their VAC Health Care Identification Card and prescription to the Blue Cross provider of their choice. If the client choses to pay for the benefit, they must forward an itemized receipt and a prescription, if required, to the appropriate VAC Regional Office or, in Quebec only, the VAC District Office, for reimbursement. Frequency and dollar limits will apply.