Claims can be submitted electronically as follows:
RX claims are adjudicated instantaneously at the pharmacy counter using your Benefit Card.
Dental claims can also be submitted electronically by your dentist. In order for a participating dental office to submit claims electronically, they must be a member of CDAnet and will require the following information:
- Dental plan provider: Manion Wilkins & Associates Ltd.
- Network provider: Emergis
- Dental plan provider identification number (BIN#): 610158
- Plan participant’s plan and certificate number: unique to plan and member, included on Benefit Card
Paper based health and dental claim forms can be submitted in the following ways:
By mail to:
Manion Wilkins & Associates Ltd.
626 – 21 Four Seasons Place
Toronto, Ontario M9B 0A6
Attention: Claims
By fax: to 416-234-2071 you must include a completed & signed claim form in your fax.
Scan & Email: to claims@manionwilkins.com you must include a completed & signed claim form in your scanned document.
In person: Claims forms can also be dropped off at our offices:
Between 8:30 AM and 5:00 PM EST to either :
Manion Wilkins & Associates Ltd.
500 – 21 Four Seasons Place
Toronto, Ontario M9B 0A5
OR
Manion Wilkins & Associates Ltd.
222 Rowntree Dairy Road, 3rd Floor
Woodbridge, Ontario L4L 9T2
After hours:
Mail Drop Box at the east side of the Four Seasons Place building.
Managed Health Care
Manion promotes a Managed Health Care approach designed to contain costs without lowering the quality of care to plan participants. A Managed Health Care solution includes drug claims payment procedures and systems which:
- Offer the option of providing coverage (fixed or customized) based on a specific Drug Identification Number (DIN)
- Contain formulary and capped dispensing fee reimbursement.
- Provide prior authorization requirements for high cost drugs
- Provide access to a list of pharmacies and their average dispensing fees
- Offer flexible reporting to manage costs on a proactive basis
Click here to access a list of pharmacies in Ontario, and here to access a list of pharmacies in all other provinces, including their current dispensing fees.
Fraud and Security
Plan members can help control costs and reduce fraud by considering the following points in relation to their medical or dental expenses:
- Be informed; know what you are paying for
- Review the explanation of benefits that accompanies your reimbursement. It provides a breakdown of the cost of each procedure and the amount reimbursed
- Safeguard your personal information, including benefit cards
Learn more about preventing health care fraud here.