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Medical Billing under Sun Life/Allianz Global Assistance 

When you have a medical appointment, you will be asked what kind of insurance coverage you have. There are a few ways to deal with this

  1. Some medical offices will bill Sunlife/World Access directly. However, they are only billed if TRICARE does not cover the service. When you initially set up your physician or go to the clinic or hospital. All medical expenses for spouses and dependants are covered by TRICARE! Confirm that this information is submitted to computers in all sections/labs that you have to deal with, e.g. blood work, x-ray, referral, etc. The address to give them to submit their claim is:  

    Allainz Global Assistance 
    Public Service Health Care
    PO Box 880
    Waterloo, ON  N2J 4C3

  2. If the establishment doesn’t accept this method of billing, tell them you will submit your claim to the insurer yourself and that you are a "self pay." You will pay for the visit immediately. You will then be responsible to submit the original bill to Sunlife/World Access Canada.

If you have medical bills of substantial amounts member is to bring a copy of them to your Orderly Room and request a medical Advance to pay them. 

After you have paid your medical bills at time of service, file a claim with your Public Service Health Care Plan (PSHCP), Sun Life/World Access of Canada. Keep a photocopy of everything you send to them, as they will not return your originals. 

Sun Life (through Allianz) will send a statement with your payment. If you only claim one medical bill, you will know which bill the cheque is for. However, if you had many bills on your claim, you may not know what part of your claim your cheque covers. To determine the amount Sun Life is reimbursing you for each separate bill, look for the “date of service rendered” on your statement and cross reference the same date on your copy of the medical bill. This will show exactly what claim was covered. There may be instances where the total claim will not be paid. If you are with EADS, the Clerk will re-submit the portion not covered using an R70 form. If you are with CDLS Washington, you will need to fill out the paperwork and submit it yourself. the Orderly Room has the R70 forms that you will need    

If you have a standing medical advance on this claim, bring the payment cheque you receive the Orderly Room, to complete the claim process.

Mail your claim to:
Allianz  Global Assistance
Public Service Health Care Plan
PO Box 880
Waterloo, Ontario, Canada
N2J 4C3

Medical coverage while traveling
If you or a family member requires medical attention while traveling, you can either pay for the service yourself and submit a claim later or you can ask to have the bill sent to Sun Life. If the hospital, clinic or physician is reluctant to do so, they can contact World Access at 1-800-321-9998 to confirm that the insurance company will pay for the service.

Sun Life/World Access Claim (works from Canada & the U.S.)

24 hour emergency line (works from Canada & the U.S.)
1-800 321-9998

World Access Fax number: 
(519) 742-8720

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Image Source: JupiterImages