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
We maintain dedicated staff 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
Our claims adjudication is done without prejudice, and verified by regular internal and external audits to ensure quality and consistency.
Our claims services ensure:
Turnaround of 2 working days
Enjoy a standard claim turnaround time of 2 working days upon receipt of claim, or even less using our online and mobile services, plus direct deposit of payment.
Explanation of benefits
All claims payment come with an Explanation of Benefits indicating eligible and ineligible items.
We are bound by strict rules governing the security and confidentiality of personal health information. We take your privacy very seriously.
We conform to Customs and Revenue Agency guidelines to protect the tax-exempt status of benefits paid from private health plans.