Delisted providers – what does it mean?

16 October 2020

Has one of your claims ever been denied because “Sun Life no longer pays for services or supplies from this service provider or facility” and wondered what happened?

The Public Service Health Care Plan is the largest health care plan in Canada. To protect its sustainability, Sun Life conducts regular verifications to ensure that providers do not engage in inappropriate billing behaviors or promote fraudulent incentives, such as encouraging you to purchase a service or product that you do not medically need.

After a careful review and investigation, if Sun Life finds that a certain provider is engaging in such activities, claims for their services or products will not be considered for reimbursement. Sun Life’s list of delisted healthcare service providers may include medical and dental clinics, facilities, service providers, as well as pharmacies. Information on delisted providers is updated regularly and can be viewed by logging in to the Plan Member Services website and selecting “Delisted providers list” located in the Benefits Centre under the Take me to navigation bar.

We encourage you to check the list periodically so that you do not unknowingly use the services of a delisted provider. You can still choose to obtain services or supplies from a delisted provider, however, your claim will be denied.

If you have any questions about delisted providers, contact the PSHCP Call Centre at 1-888-757-7427 (toll-free) or 613-247-5100 (in the National Capital Region).