My customer isn’t happy with their claim adjudication, who should they speak to?
TELUS Health Solutions administers drug plans on behalf of major Canadian Life Insurance Companies. They have given us the mandate to deal with pharmacies and other electronic providers on their behalf in order to facilitate the operation of their various pay-direct benefit programs. The insurers value and want to maintain their relationships with plan sponsors (employers) and their employees and have asked that we have no direct connect with either constituency. We respect their wishes. We realize that this can occasionally put the pharmacy in the situation of dealing with an unhappy customer. Sometimes it’s unavoidable. Our Support Centre tries to provide you with as much information as possible to help your customer; but sometimes, it’s not enough to overcome the problem. In such cases, all you can do is advise your customer to contact their employer’s plan administrator in order to get satisfaction from the insurer. If the issue has resulted in non-payment of the claim, your best c
