Non-Insured Health Benefits (NIHB) NewsLetter
First Canadian Health
News and Information for our NIHB Providers
NIHB TOLL-FREE INQUIRY CENTRE: 1-888-471-1111
For our Medical Supplies and Equipment Suppliers - Winter 2003-2004
News and Views
Welcome to the winter 2003 edition of the Non-Insured Health Benefits
(NIHB) quarterly newsletter. First Canadian Health (FCH) is now
in its fifth year of operations as the claims processor for the
NIHB Program of the First Nations and Inuit Health Branch (FNIHB)
of Health Canada.
Again, FCH would like to thank you for your support as you continue
to provide quality health services to First Nations and Inuit clients
of the NIHB Program.
As always, your comments and questions are welcome. Please contact
the FCH NIHB Toll-Free Inquiry Centre Representatives at 1-888-471-1111,
or send your correspondence to:
FCH Provider Relations 3080 Yonge Street, Suite 3002
Toronto, ON M4N 3N1
Service Date
When submitting claims, providers are reminded that the date entered
in the “DATE OF SERVICE” field on the NIHB MS&E Claim
Form must be the date that the client receives the service or takes
home the completed item. If an item must be mailed, then the date
of service must be the date that the item is mailed.
Items that are on back-order cannot be claimed before the client
receives the item. Items and services claimed prior to the date
of service are subject to reversal or reclaim through the audit
process.
For further information on NIHB MS&E Claim Form required data
elements, please refer to Section 7.5 of your NIHB MS&E Provider
Information Kit (MPIK).
Quantity Limitations For MS&E Items
MS&E items that have a prior approval and an annual quantity
limitation may only be provided and claimed for no more than a
three-month period at a time. For example, if an item has a limitation
of 12 per year, then a maximum of 3 may be provided and claimed
for during a three-month period. Any quantities in excess of the
amount allowed during the three-month period will be subject to
reversal or reclaim through the audit process.
For further information on claim submission with a prior approval,
please refer to Section 7.1.3 of your NIHB MS&E Provider Information
Kit (MPIK)
Clarification Regarding Services Provided by Certified Canadian
Pedorthists C Ped (C)
Certified Pedorthists that are registered with the NIHB Program
can provide the following services: custom made footwear, custom
made internal footwear device and modifications to stock footwear
to eligible NIHB clients.
Band #458 – Bigstone Cree Nation
The Bigstone Health Commission has assumed complete management
of MS&E benefits on behalf of the members of Bigstone Cree
Nation (Band #458). This means that in the near future claims for
members of Bigstone Cree Nation will become ineligible for payment
through First Canadian Health (FCH), which administers the Health
Information and Claims Processing System (HICPS) on behalf of the
NIHB Program. Bigstone Cree Nation will communicate to providers
a specific date when claim payments will be discontinued by FCH.
At that time, prior approvals and claims for services provided
to the members of Bigstone Cree Nation should be submitted to:
Bigstone Health Commission
Attn: Mabel Gladue
P.O. Box 1590
Wabasca, AB T0G 2K0
Phone: (780) 891-4161
Fax: (780) 891-3222
Toll Free: 1-866-891-9719
Published quarterly by First Canadian Health Management Corporation
Inc. at 3080 Yonge Street, Suite 3002, Toronto, ON M4N 3N1
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