PSHCP Members residing in Canada are now able to submit their most common health claims electronically through Sun Life’s Plan Member Services website or the my Sun Life Mobile application. A total of 53,472 claims have already been submitted electronically in the month of April alone.
When submitting a claim electronically, Plan members can enter up to eight different claims in one transaction. Claims submitted electronically are adjudicated immediately and, if approved, any reimbursement amount is usually deposited directly into the member’s bank account within 24 to 48 hours. However, if the claim requires additional review or information, the processing time will be longer. Members must keep their receipts for 12 months as information may be requested to substantiate services or products that have been claimed.
The implementation of digital services is an important expansion to Sun Life’s service offering. In addition to electronic claims submission, PSHCP members have an array of digital services at their fingertips such as the Drug Look-Up tool, the Provider Search, Click to Chat, and the PSHCP benefit card email notifications.
To benefit from these services, members must register on Sun Life’s Plan Member Services website. Sun Life will require email addresses and banking details so that claims may submitted electronically.
Drug Look-Up Tool
The Drug Look-Up tool was launched in April 2017 on Sun Life’s Plan Member Services website. This feature provides members with up-to-date, doctor-approved information on drugs and confirms eligibility under the PSHCP. Drug Look-Up also allows members to:
- search for a specific drug by name or by drug identification number (DIN);
- obtain detailed information about a drug, its indications and clinical use;
- access information about potential generic and/or therapeutic alternatives as well as cost-saving solutions;
- confirm whether or not a drug is covered under the PSHCP, its average cost per prescription and the cost of any alternatives suggested; and
- review claims summaries for recent prescriptions.
The information provided by the Drug Look-Up tool reflects the basic coverage under the PSHCP and should not be considered as a recommendation or treatment plan. However, by using the tool, Plan members will be better prepared when having informed discussions with their health care professional about prescription medications.
PSHCP Benefit Card Email Notification
The PSHCP benefit card email notification feature was launched in May 2018. The email informs members when a transaction using their PSHCP benefit card has been processed at the pharmacy. However, an email will not be sent to the member when medical supplies are purchased at the pharmacy using the benefit card.
The Provider Search feature enables members to find local providers quickly and efficiently with over two million ratings. Its rating system also gives members the ability to rate providers.
It is important to note that the PSHCP does not provide coverage for all providers listed, such as dietitians or acupuncturists.
Click to Chat
Beginning on July 4, 2018, the new Click to Chat feature will enable Plan members to connect directly with Sun Life representatives in real time through its secure website.
Members will be able to access the new feature by signing in to mysunlife.ca/pshcp and clicking on the “Chat live now” icon from the top navigation bar within all pages of the secure website. A terms and conditions statement will appear once the chat is initiated. The chat will be available from Monday to Friday between 9:00 a.m. and 5:30 p.m. EST.