Claim Reimbursements by Direct Deposit

Please be advised that effective October 1, 2019 Pacific First will no longer be issuing claim reimbursements by way of cheques. Instead, enrolment in the direct deposit program for health and dental benefit payments will be mandatory for all claim reimbursements.  We will require all members to provide our office with an email address in order for them to receive their electronic Explanation of Benefits.

In accordance with this new claim disbursement procedure, all enrolled employees are to provide our office with a VOID sample of a cheque or Direct Deposit form from their bank or online banking site. Please ensure this information is delivered to Maria Koronko at maria@pacific-first.com to avoid delays with any of your teams claim reimbursements.

The implementation of Direct Deposit will be of great benefit. We thank you for your cooperation in helping make this a smooth transition.

Online Employee Account Activation

Employee online access is available via your smartphones and tablets.  These devices may be used to make a claim or to review the status of your account online.

Employees do not have to set up an account in order to make a claim online. Setting up an account enables you to review your personal information (address changes, dependent information, etc.) and to view the status of your claims.

Instructions on how to activate an online account

Go to www.pacific-first.com

–           Click on ‘Activate your account’

–           Enter your Plan Number (ie: P11222)

–           Enter date of birth

–           Enter first name

–           Enter last name

–           Click ‘Submit’

This will go to ‘Set Your Username’

–           Enter your email address under ‘New Username’

–           Click ‘Submit’ button

This will go to ‘Set Your Password’

–           Enter the password you want to use

–           Re-enter the password to confirm

–           Click ‘Submit’

Then continue to ‘Login’ or leave the site

To ‘Login’ to the site

–           Click ‘Login’ button

–           Enter your email address

–           Enter your password

–           You will then be logged into your account to check your claims, etc.

If you have any questions, please contact Pacific First at the numbers and/or email below.

How to Submit an Online Claim

Go to www.pacific-first.com. At the top right hand corner, click on “make a claim”.

Personal Information Section

Items marks with an * is required information.

Enter your employer name:              ABC Company

Enter your first name:                         Bob

Enter your last name:                          Smith

Enter your middle name:                   Edward

Enter your email address:                  bob1111@hotmail.com

Enter your plan no:                             ie:   P11111

Date of Birth:                                        Select your date of birth from the calendar

Direct Deposit – If you are already signed up

If you are already signed up for direct deposit, you do not have to complete this section.  Continue to next step.

Direct Deposit – Sign up for Direct Deposit

Sign up for direct deposit by clicking on the “Yes” button. You must upload a copy of your VOID cheque to us.  Select the “attach void cheque” button. Locate your photo or attachment and double clicking it to attach or select open and your document should upload successfully.

Terms of Use

The terms of use document must be read (click on “See More”) to ensure you agree to the terms of using the online claims submission.  To close terms of use, hit X at top right hand of document.  If you agree – click yes.  If you do not, you cannot make an online claim submission.

To complete the Claim section:

Under Claim Details

Enter patient name

Date of purchase

Description of service (ie: drug name or chiropractor)

Claim amount

 Copies of all claim receipts must be submitted (and legible)

Beside Claim Amount, click on Claim Uploads to upload the document (ie: drug receipt). Attach the copy of the corresponding receipt.

Click on Claim Details tab again to enter next claim and continue until all claims are entered and uploaded.

After all claims have been entered, click on the Claim Details tab.

At the bottom of the page, click the “Submit Claim” button.

You will see a note that says the claim was successfully submitted.  If something is missing, it will tell you what is missing or incorrectly entered (change as required).

A confirmation note is provided; you can either hit “Print” or close out of that window.

A confirmation of receipt email will be sent to the email address provided.

If you have any questions, please contact us: https://www.pacific-first.com/contact-us

What you need to know about submitting Health & Dental Claims

Submit your benefits claims online at www.pacific-first.com – get your money back fast by having Direct Deposit set up!

3 ways you can submit your health and dental claims

  • Your dental claims may be submitted directly to Pacific First by your dental office
    Check with your provider.
  • Use our secure online site
    Sign in or register to your online account and select submit a claim. It’s just that simple.
  • Mail in a paper form
    Fill in, print, and follow the mailing instructions on the form.

Tips to ensure your claims are processed and paid quickly

  1. To consider a claim, Pacific First must receive health and dental claims within 365 days of the date when the expense was incurred or no later than 30 days after your coverage ends, whichever is sooner.
  2. Include all original receipts unless we are topping up for another carrier, in that case we require copies of your receipts and the original report from your other carrier.
  3. Make sure your receipts include:
      • patient name
      • date of service
      • nature of treatment (eg. massage therapy, physiotherapy)
      • name of provider including their credentials and/or registration number
      • cash register tapes are not acceptable
      • dental claims – have your dentist print a Standard Dental Claim Form for you to submit to us for reimbursement
      • Prescription Drugs – Official pharmacy receipts are required. Please contact your pharmacy for a duplicate copy if required
  1. Certain types of service or supplies may require a medical referral/physician prescription and/or prior authorization.
  2. Ensure you contact us with any address changes.
  3. Make sure to sign the claim form.
  4. For tracking purposes, please keep copies of all claims and take note of the day they were submitted.

PLEASE NOTE THAT IF YOU DO NOT COMPLETE A CLAIM

FORM, YOUR CLAIMS WILL BE RETURNED