Medavie Blue Cross has been a reliable partner for federal and provincial governments since 1943. We have the scalability, expertise, technology and the flexibility to meet our government clients’ diverse needs in delivering a range of health care services.
Our Government Programs team has highly-developed expertise in the government environment, program administration and the intricacies of the health care industry. We are also supported by an extensive group of professional health consultants, including physicians, pharmacists, and nurses. Our team contributes to a broad range of health-related activities, including participation on both national and provincial-level committees.
Medavie Blue Cross has been in the business of electronic claims processing for more than 20 years. We have sophisticated online adjudication systems with the capability and flexibility to handle a wide variety of program requirements. Our claims processing systems and administration expertise provide our clients with a streamlined process leading to trust and confidence in our service delivery.
Medavie Blue Cross Government Programs Division administers health care benefits and services on behalf of our federal and provincial clients. Our scope of services in benefit management has continued to grow and adapt, enabling us to customize solutions for our clients.
Medavie Blue Cross monitors the prescribing of narcotic and controlled drugs through the administration of a Prescription Monitoring System. Our system is the only fully electronic, online, real-time system in North America designed to communicate with existing pharmacy software. Real-time submission of data has involved processing more than 450,000 prescriptions annually.
Medavie Blue Cross has been a leading service provider in the area of drug program management for more than 40 years. Our unparalleled experience in administering federal and provincial government drug programs has uniquely positioned Medavie Blue Cross to address clients’ requirements for the development, implementation and administration of drug programs. Our sophisticated online drug adjudication system has the capability and flexibility to handle a wide variety of plan designs with various rules and restrictions based on our clients’ unique requirements.
Our Provider Registry Network is a national network of registered health care and service providers. This network is a comprehensive registry of licensed and qualified medical practitioners, facilities and home care providers who can be reimbursed directly on a regular basis. Provider records management includes advanced credentialing and quality control administration of all registered providers in our advanced registry database. Our Provider Registry Network is utilized nationally for our federal and provincial government clients.
Audit Services plays a key roll in ensuring the financial integrity of our clients’ programs. Financial accountability and tracking can take the guesswork out of where program dollars are being spent. At Medavie Blue Cross, we're a leader in providing retroactive audit and investigative services. We develop and implement monitoring systems and procedures to determine, on a post-payment basis, whether claims are valid and appropriately billed under our clients’ programs.
Due to the nature of our business, we take the issue of privacy very seriously. We meet all Government Security Policy requirements and ensure your clients’ personal information is protected. Strict security policies are imposed and enforced by our Security Officer. Our employees are subject to criminal background review prior to being hired and are educated on all security requirements.