Who is this article for?
Most claims are processed by the insurer in a few seconds. Some are not: the insurer reviews them by hand, refuses them, or cannot process them electronically. This article explains what to do in each case.
| Status | What it means | What to do |
|---|---|---|
| Pending (under review by the insurer) | The insurer received the claim and reviews it by hand. | Do not submit it again (it would be a duplicate). The insurer sends the result directly to the payee, outside Colib: the status does not change in Colib. Once you know the result, record the payment on the invoice if you were paid. |
| Refused by the insurer | The insurer processed the claim but covers nothing (for example, service not covered or annual maximum reached). | Read the reason in the message and in the insurer's PDF, give the PDF to the client and collect the invoice from the client. If the refusal comes from a mistake in the claim, cancel it the same day, correct and submit again. |
| Error | The insurer cannot process this claim electronically (for example, deadline exceeded or plan not eligible). | Submit the claim manually on the TELUS Health eClaims platform, or give the client their receipt. If the error comes from information you can fix, correct it and submit a new claim from the invoice. |
To find these claims, filter the Insurance claims dashboard by status: please see the article titled "How to follow your claims in the Insurance claims dashboard".
Good to know
- A new claim — a claim in Error does not block a new claim on the same invoice. A pending or refused claim does: cancel it the same day if needed.
- Messages before sending — when Colib blocks the claim before sending it, nothing is sent to the insurer: please see the article titled "How to fix the errors when submitting a TELUS Health eClaims claim".
Related articles
- Please see the article titled "How to submit a claim through TELUS Health eClaims".
- Please see the article titled "How to cancel a TELUS Health eClaims claim".
- Please see the article titled "How to fix the errors when submitting a TELUS Health eClaims claim".
- Please see the article titled "How to follow your claims in the Insurance claims dashboard".
Still have a question?
Write to us at support@colib.io, we will be happy to help.
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