Claims Payment

groupSource has been adjudicating health and dental claims on behalf of partner underwriters since 1989.

Claims adjudication is the application of group policy guidelines and provisions to pay claims. It involves personal medical information which requires privacy and confidentiality protection.

This is achieved through:

Our claims adjudicators

who process claims and answer inquiries about specific claims issues in a timely manner as well as research discrepancies and contact providers to obtain missing information

adjudication to the highest standards

without prejudice and verified by regular internal and external claims audits to ensure quality and consistency

Our claims services ensure:

Turnaround of 2 working days

standard claim turnaround time of 2 working days upon receipt of claim

Explanation of benefits

payment with an Explanation of Benefits indicating eligible and ineligible items

Security

and confidentiality of personal claim information

Thorough processes

that conform to Customs and Revenue Agency to protect the tax-exempt status of benefits paid from private health plans.

Employee Resources

Administrator Resources

Advisor Resources

News and Events

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