The First Nations Health Authority (FNHA) has transitioned the administration of its medical supplies and equipment (MS&E) benefits to BC-based benefits provider, Pacific Blue Cross (PBC).
Registrant should submit all new MS&E claims and pre-determinations (PDs) for FNHA clients to PBC using the policy number 40000. Member ID numbers will be the same as clients’ Status Numbers.
Hearing Instrument (MS&E) Benefits Plan Highlights
- PDs are not required for hearing assessments and hearing aids.
- Clients are eligible for hearing aids every five years with a maximum coverage price of $1,083 per hearing aid. Hearing aid repairs are covered but must not exceed the cost of replacement as set by the FNHA. Repairs exceeding $300 may be reviewed and require additional documentation.
For benefits that require PDs, PBC will accept paper PD forms submitted by mail (PO Box 7000, Vancouver, BC V6B 4E1) or fax (for FNHA clients only: 604.677.0277).
What do Registrants Need to Do?
- Register with PBC
PBC-registered providers can log in to the online portal, PROVIDERnet, where they can directly bill PBC and check client benefit coverage. The online portal provides a streamlined adjudication process for greater efficiency.
If you are registered through one of PBC’s sister organizations, such as Medavie Blue Cross, please note that the two are not connected for the administration of the FNHA MS&E benefits. Please ensure you register as a Provider with PBC and sign up for PROVIDERnet.
- Review Resources
FNHA and PBC have posted resources on their websites. Please review the following documents to find further information about how to submit claims, check eligibility and find details about the FNHA MS&E benefits plan:
- PBC Hearing Instrument Provider Reference Guide (PDF)
- Hearing Fee Supplement for Clients of the FNHA (PDF)
Is FNHA Still the Last Payer (coordination of benefits)?
Yes, the FNHA MS&E benefits plan administered by PBC will remain the last payer. If an FNHA client has access to another public (e.g., provincial) or private benefit plan, their claims must be submitted first to that plan for coverage. If the fees are above the maximum limit of the benefit coverage, please inform clients of the out-of-pocket costs in advance.
What Number can Registrants Call?
If you need assistance, please call PBC at 604.419.2000 or toll-free at 1.877.PAC.BLUE (1.877.722.2583).
For questions about the Reference Guide and Fee Supplements, claiming or registration, and how to log in, please visit PROVIDERnet website.