Emergency Travel Claim

The typical processing time for an emergency travel claim can vary between 10 business days to several weeks, depending on different scenarios. After reviewing your claim, the scenarios can include:

• Your claim is approved, and the medical provider is paid directly.
• Your claim is approved, and you are eligible for reimbursement.
• Your claim is approved but is sent to a third-party negotiator to help reduce the cost of the medical services charged.
• Your claim is pending with a request sent to the medical provider for more information.
• Your claim is pending with a request to you for more information.
• Your claim is denied.

As a reminder, submitting proper documentation is a crucial step in ensuring your travel claim is processed. Most claim delays or denials are because the proper documentation is not submitted.

ASEBP does not share covered members’ banking information associated with their ASEBP benefit plan profile. This means that CanAssistance requires you to provide your banking information on either their claim form or ASEBP’s Emergency Travel Claim form to issue your reimbursement for your emergency travel claim, if eligible.

Your banking information is used during your emergency travel claim process only. CanAssistance does not store this information.

If banking information isn’t provided, CanAssistance will issue a reimbursement cheque via Canada Post.

Most claim delays are because proper documentation is not provided during the submission process. Collecting and submitting the required documentation will reduce claims being delayed. These required documents include:

• Doctor’s notes
• Hospital admission forms
• Diagnostic test results
• Dental x-rays
• Hospital discharge summary
• Itemized invoices that include:
  • Patient’s name
  • Date of service
  • Description of diagnosis and treatment
  • Amount charged and currency
• Itemized prescription drug receipts showing the name of the drug, the dosage, and the price.
• Proof of payment of all expenses paid and the currency they were paid in such as:
  • Credit card statement
  • Proof of deposited cheque
  • Receipt (if credit card statement or proof of deposited cheque isn’t available)
• Proof of travel and return such as:
  • Flight tickets and boarding passes (if flying)
  • Copy of your passport entry and exit stamp (if applicable)
  • An official document that outlines your name, date, and location such as a credit card statement (if driving).

If you are unsure which information needs to be resubmitted or why your claim was not approved, please refer to your Explanation of Benefit document(s) and contact ASEBP at benefits@asebp.ca or 1-877-431-4786.

A claim may be sent to a third-party negotiator by CanAssistance to negotiate the final amount to be paid to the provider. Some medical providers will offer different rates for services depending on how the invoice is being paid, with payments from insurance companies being charged the most.

The negotiation, which aims to reduce the amount the provider charges for treatment, can take between four to six weeks.

If payment is outstanding beyond the provider’s payable grace period, they may send you a direct bill or send the account to a collection agent. This can happen if there are delays in processing a claim such as missing information or if a claim has been sent to a third-party negotiator.

If you receive an invoice from a provider or a collections notice, please contact ASEBP at benefits@asebp.ca or 1-877-431-4786. Do not make payments directly to the service provider or to the collection agent.

You will receive an Explanation of Benefits (EOB) from CanAssistance via Canada Post and on My ASEBP if your claim is approved and you are being reimbursed, if a claim is pending and requires more information, or if your claim is declined.

If your claim is approved and payment is made directly to the provider, you may not receive an EOB.

CanAssistance EOBs may look different than ASEBP EOBs. Please contact ASEBP if you have questions about your emergency travel claim EOB.

Your claim can be declined because proper documentation was not provided during the submission process.

Along with the required medical and financial documentation, CanAssistance requires you to provide proof of travel and return to confirm if the travel duration meets the trip duration maximum covered by your ASEBP benefits:

• 183 days for Group, Supplemental, and Early Retirement Plans
• 100 days for MyRetiree Plan

Ensure you provide documentation with your or your dependants name(s), the date the document was created, and the location the document was generated for both your or your dependants’ departure and return. This can include:

• Flight tickets and boarding passes (if flying).
• A copy of your passport entry and exit stamp (if applicable).
• An official document that outlines your name, date, and location such as a credit card statement (if driving).

Your claim may also be declined if you submitted an emergency travel claim for an ineligible expense. For example, routine medications are eligible under your regular drug coverage when they are purchased in Canada during the covered refill period. Routine medications submitted with an emergency travel claim will be declined. If the medications were purchased in Canada, they must be submitted under an Extended Health Care claim. ASEBP recommends you speak with your healthcare provider or pharmacist about your prescriptions before your departure date to ensure you have enough supply to cover the length of your entire trip.

Review the Travel page as you plan your trip to review what is and what is not covered by your ASEBP Emergency Travel Benefits.

You are still covered under your provincial or territorial health care insurance plan when you are travelling. Provincial and territorial health plans are the primary payor for emergency medical travel claims, and your emergency travel benefits are activated only after coverage limits under the provincial or territorial health care insurance plan have been reached.

Completing and submitting the correct provincial or territorial Out-of-Country Authorization and Consent form will help reduce processing time. CanAssistance includes

ASEBP’s Emergency Travel Claim form includes Alberta’s Insurance Claim Authorization and Consent form. If you reside outside of Alberta, ASEBP recommends visiting your provincial or territorial health care website to find the appropriate out-of-country authorization and consent forms.