How to submit claims to GreenShield

Important information regarding submitting claims:

It is important that all forms be completed in full, including the appropriate identification number and payment receipts, to avoid delays in processing claims. We recommend you keep a copy of all items submitted. 

All claims must be submitted to GreenShield within 12 months from the end of the calendar year in which the expenses were incurred to be eligible for reimbursement.

For example, all eligible expenses incurred in 2024 must be submitted by the end of 2025. On any occasion when a significant expense is expected, employees are encouraged to submit a cost estimate or predetermination/treatment plan to GreenShield beforehand. This can be done by having the practitioner provide a predetermination of benefits. Procedure coverage and reimbursement amounts will be communicated by GreenShield directly to the member.

GreenShield has multiple options for claims submission:

  1. Self-Service online claims: Through this service, you pay for the medical product or service, then submit your claim online through the GreenShield+ website or app. Please refer to the Online Claims Facts sheet for additional information, or see the steps listed below. Note: You must register your account with the GreenShield+ member site (or app) to submit a claim online or through the app. 
     
  2. Direct billing through your provider (provider submits claims on your behalf): Many health service providers will electronically submit claims on your behalf. As of January 1, simply present your GreenShield benefits ID card and ask them to submit your claims directly to GreenShield. All the information they will require for direct billing is on the card. If they have any difficulty with registration or claims submission, have them call GreenShield Customer Contact Centre.
     
  3. Paper claims: For claims that are not submitted electronically, either by you or your provider, simply pay for your item or service and mail the paid receipt and claim form for reimbursement to GreenShield at the address indicated on the claim form.  
 Where to find claim forms for printing (or pre-printed):

Claim submission step guides:

The following documentation on the GreenShield support centre shows the steps you can follow to submit a claim.  Questions about how to submit a claim should be directed to GreenShield.  

Step 1

It is extremely advantageous to know what your policy does and does not cover in advance of cost so you can know what charges you will incur.

Step 2

Once you have determined you are eligible for an expense, the procedure on how to submit a claim is listed in Step 2. 

Select the appropriate paramedical service for your claim:

When submitting claims through GreenShield+, the appropriate paramedical service type must be accurately selected based on your provider's designation. If the wrong service type is selected, your claim may be denied and re-submission with the correct service type may be required.

Use the matrix listed below to select the appropriate service type.

Designations can be found on your receipt from our provider and are typically found next to your provider's name. If there is no designation listed on the receipt, contact your service provider to confirm their designation.

Service Type Designation
Masters of Social Worker MSW - Masters of Social Work
Psychologist Ph.D. - Doctor of Philosophy
Psy.D. - Doctor of Psychology
Ed.D. - Doctor of Education
D.Clin.Psy. - Doctor of Clinical Psychology
D.Clin.Psychol. - Doctor of Clinical Psychology
D.Clin.Psych. - Doctor of Clinical Psychology
D.Ed. - Doctor of Education
D.Litt et Phil. - Doctor of Literature and Philosophy
D.Ps. - Doctor of Psychology
D. Psych. - Doctor of Psychology
Dr. rer, Nat. - Doctorate in Natural Sciences
M.A. - Master of Arts
M.Ed. - Master of Education
M.Sc. - Master of Science
M.A.Sc. - Master of Applied Science
M.App.Sc. - Master of Applied Science
M.Sc.Ed. - Master of Science Education
M.Phil. - Master of Philosophy
MPhil. - Master of Philosophy
M.C. - Master of Counselling
Dip. Couns. Psychol. - Diploma of Counselling Psychology
B.A. - Bachelor of Arts
Psychotherapist Registered Psychotherapist (RP)
Eye Exam If you had a routine/standard eye exam (also known as oculo-visual assessment)
Diagnostic Vision Test All Other Exams that are not routine/standard

Please note: this list is not inclusive of all designations/services eligible under the plan.

It's important that the designation of the provider you visited is used as the Service Type, rather than the services that they performed for you.  For example:

  • If you obtained counselling services from a mental health provider with a MSW designation, select Masters of Social Work.
  • If you obtained counselling services from a mental health provider with one of the 22 Psychologist designations, select Psychologist.
  • If you obtained counselling services from a mental health provider with a Registered Psychotherapy (RP) designation, select Psychotherapist.
  • If you obtained counselling services from a mental health provider without one of the above designations, your expense is not eligible for reimbursement through the extended health benefit.

If you cannot locate your provider, they are not registered with GreenShield and you will not be able to submit your expense through GreenShield+.  Please contact GreenShield with your provider's contact information (either through the contact centre or by paper claims submission) so that GreenShield can connect to your provider to obtain a copy of their designation. The provider's credentials will need to be obtained before your expense can be adjudicated.

If you require any assistance during this process, please reach out to GreenShield directly.

Contacting GreenShield:

Phone (Mon to Fri, 8:30 a.m. - 8:30 p.m. ET):

  • 1-888-525-7587, select "Option 1", or 
  • 1-888-711-1119 

Online: 

Inquiry support:

Experiencing problems with a benefit claim?

The following steps of the GreenShield Inquiry Support Model can help to resolve the problem.