Medical Supplies And Equipment Claim Form Nihb

Prior approval must be sought with written medical justification from the nihb regional office.

Medical supplies and equipment claim form nihb. Complete the nihb client reimbursement form online or print it out. Documents required by the nihb program to reimburse costs related to health services can be found on the next page of this form. Many health service providers are once again scheduling routine and non emergency appointments as part of bc s restart pl an health benefits coverage continues to be available so that you can access the medical supplies and equipment you need. Coverage may be provided on a case by case basis for items not listed under exclusions.

Medical supplies equipment forms. Medical supplies and equipment service update. The following medical supplies and equipment lists contain the products and services provided as eligible benefits by the non insured health benefits nihb program along with information on coverage policies benefit codes requirements for prior approval and applicable recommended replacement guidelines. This is not an assessment form.

This form may be used to recommend medical supplies and equipment eligible for coverage under the non insured health benefits program. Programme des services de santé non assurés ssna. Medical supplies and equipment guide and benefit lists. Not what you are looking for.

The recommender must do a complete assessment prior to completing this form. To submit a client reimbursement request by mail. Complete the nihb client reimbursement form online or print it out. Non insured health benefits nihb program hc nihb august 2011 nihb client reimbursement request form.

Submit the completed and signed form along with all receipts and supporting documents to 1 888 249 6098. Non insured health benefits nihb for eligible first nations and inuit. The nihb program reserves the right to request this form for audit purposes. Nihb general medical supplies and equipment prior approval form.

Exceptions are medical supplies and equipment that are not currently listed on the nihb medical supplies and equipment benefit lists. Your authorization in order to collect information from your provider for services provided to you and paid for by the non insured health benefits. Go back to the express scripts canada website. Formulaire de demande de paiement.

Medical supplies and equipment claim form. Medical supplies and equipment. Please note that all nihb policies and requirements for coverage apply.