For Insurers and Employers

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Responsive

Flexible solution

Our easy-to-use rules-based solution can be customized by the insurer to adapt to evolving business needs. An all-in-one claims solution (dental, drug, extended healthcare) is also available for easy adjudication of all claims.

Flexible solution

A platform that can evolve

A state-of-the-art platform, designed to be modular, interactive and flexible so it can evolve with customers’ needs – after deployment the model can be easily adjusted along the way

A platform that can evolve

We're with you all the way

Access to a specialized team of experts with years of experience with Claims management

We're with you all the way

Efficient

A single platform for multiple claims

Ability to handle multiple benefits (dental, extended healthcare, drug claims and member claims) using a single platform

A single platform for multiple claims

Satisfied plan members

Greater plan member satisfaction by providing pre-determinations and adjudication responses at point-of-service, cutting reimbursement lag times and out-of-pocket expenses

Satisfied plan members

High precision

Automated solution with high-precision, offering simple, straightforward claims input and accurate patient claims processing

High precision

Effective

Cost savings

Cost savings in operational expenditures result from reductions in paper claims handling and call centre support usage

Cost savings

Paper claims management

Outsourced paper claims managed by the insurer or TELUS, in whole or in part

Paper claims management

Fully compliant

Compliant with the Canadian Dental Association and the Association of Dental Surgeons of Québec standards for the electronic transmission and processing of claims

Fully compliant

How it works

With TELUS Health, dental claims can automatically be processed on behalf of the patient at the point-of-service and then adjudicated in real time, quickly and accurately, with superior anti-fraud controls. Insurers also receive a complete dental claims management solution built on TELUS Health’s experience and expertise gained from processing millions of electronic claims every year.

TELUS Health Dental Claims offers:


  • Dental Claims Exchange: Perfect for insurers and payers who have their own adjudication system, this allows for the transportation of claims between dental providers and insurers for quick processing of claims. In this scenario, the claims are dispatched and validated by TELUS Health, then sent to the insurers’ system for adjudication via TELUS Health’s reliable and secure exchange systems.
  • Dental Claims Adjudication: If an insurer is without an adjudication system, TELUS Health can provide a complete and worry-free solution. In this scenario, insurers have access to an intelligent and flexible platform, tailored to their needs. With TELUS expertise and technology, leading quality and anti-fraud controls, and the ability to offer payment to plan members on behalf of the insurer, TELUS Health Dental Claims offers the most complete solution for insurers.

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