WebClaim Form for Vision EN (Rev. 2011-09) VIS CLAIM FORM FOR VISION CARE SERVICES Please use one form per practitioner, per patient. ... 739-1133 EMAIL ADDRESS WWW.GREENSHIELD.CA PLEASE INDICATE ON MAILING ENVELOPE: GREEN SHIELD CANADA P.O. BOX 1615, WINDSOR, ON N9A 7J3 ATTENTION: … WebGreen Shield Canada. 5140 Yonge St, Suite 2100. Toronto, ON M2N 6L7. Fax: 416.733.1955. Email: [email protected]. If you would like to initiate a search for unclaimed property, please complete this GSC Unclaimed Property Request Form and include it with your submission to the Ombudsman.
CLAIM FORM FOR MEDICAL DEVICES - providerConnect
WebThe following information is required on the claim form: Green Shield Canada ID Number: Your GSC ID number begins with your school's three-letter code, followed by your student ID number, and ends in -00. Example: RSU123456789-00 ... can call Green Shield Canada weekdays from 8:30 a.m. to 8:30 p.m. ET at 1-888-711-1119 or email them at customer ... WebFor Health & Dental claims inquiries and specific claim forms, contact Green Shield Customer Service at 1-888-711-1119 conversely online along www.greenshield.ca. Health & Dental claims can plus exist submitted electronically by using Greenish Shield’s Web-based Services, GSC everywhere. ... Found a Policyholder Claim Form. Canada/USA … sharky\\u0027s soft play henfield
CLAIM FORM FOR MEDICAL DEVICES - providerConnect
WebComplete Greenshield Claim Forms online with US Legal Forms. ... your concern with a GSC Customer Service Representative toll-free at 1.888. 711.1119 or by email at … WebCLAIM FORM FOR MEDICAL DEVICES Please use one form per practitioner, per patient ... writing to GSC at [email protected], but, if you do so, GSC will no longer be able to administer your benefits plan and process your claims. Name Signature Date SECTION 5 - ASSIGNMENT OF BENEFITS WebBy signing this claim form and/or submitting actual receipts, I agree that the information provided is complete and accurate. I understand that the information provided by me to Green Shield Canada about myself and my dependents, will be used by Green Shield Canada for claims adjudication and any other population of galena illinois