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Claim Submission Guidelines
Did you know?
For most extended health, dental and drugs claims, active Plan Members can submit their claim up to 12 months from the date of occurrence, regardless of year-end or calendar date.*
*exclusion apply, refer to your policy for specific, submission guidelines
Download the Informational PDF "Claim Submission Deadline" to learn more!
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Health and Dental Claims
RWAM Plan Member Services Website
Claims can be submitted online by signing in to the Plan Member Services website.
- Register for Plan Member Services and provide your direct deposit banking information and email address.
- Submit your claim by answering a few simple questions and attaching an electronic copy of your receipt.
- Payment will be deposited directly into your bank account and you will receive a Claim Statement / Explanation of Benefits (EOB) via email.
RWAM Mobile App
You can enjoy the on-the-go convenience of the RWAM Mobile App, once you have registered for Plan Member Services.
Submitting a claim with the RWAM Mobile App is as simple as taking a picture of your receipt and answering a few questions.
Download the RWAM Mobile App from your Device's App Store
Paper Form
Submitting a claim using the traditional paper form still works.
- Claim forms are available on our Forms page.
- Complete the appropriate claim form, attach your original receipts and mail them to RWAM (retain a copy for your records).
- To avoid unnecessary delays, complete the Direct Deposit form and your claims payment will be deposited directly to your bank account.
Provider Direct Submission
Once you have registered for Plan Member Services, you can ask your Healthcare Provider to submit your claims to RWAM for immediate adjudication and information regarding the eligibility of your claim. Eligible reimbursement may be made directly to your bank account or payment can be made to your Provider.
For more information on Provider submission of claims visit our Provider eServices page and Provider FAQs page.
Are you covered by more than one benefit plan?
Coordinate between multiple plans to maximize your coverage. Review the Coordination of Benefits page and receive up to 100% coverage for eligible expenses.
Drug Claim Submission Requirements
Submitting Your Prescription Claim With RWAM Is Easy!
To submit your claim, you will need to scan or take a picture of your official prescription receipt ensuring all information is clearly visible and there are no shadows, markings or obstructions. Use the RWAM Plan Member Services website or RWAM Mobile App to submit your claim, attach the photo or scanned copy of the official prescription receipt, and click “Submit”. It’s that easy!
For prescription drug claim submissions, RWAM will require an official prescription receipt – often you will find it attached or inside your prescription takeaway package you receive from the pharmacy.
Receipt MUST Include:
Patient Name: The name of the patient that was prescribed and will use the medication must be clearly visible.
Drug Name and/or DIN: The name of the prescribed drug and/or the Drug Information Number (DIN) must be clearly visible.
Amount Charged: The total cost including drug cost, fees, and if applicable the amount covered by your drug plan must be clearly visible.
Informational PDF “Drug Claim Submission Requirements”.
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All Other Claims
Travel Assist
For Out-of-Province / Out-of-Canada (OOC) Claims complete the Travel Assist Out-of-Canada / Out-of-Province Claim Form.
Critical Illness
Contact your Plan Administrator or Contact Us for Critical Illness claims assistance.
Disability
Appropriate claim forms based on your group's coverage are available from your Plan Administrator or Contact Us.
Life Insurance or Accidental Death & Dismemberment
Contact Us and ask for Life claims assistance.