Request a pooled Health/ Dental claim listing

Order a standard report

You can order a standard report that includes:

  • information about all divisions
  • information for all service codes
  • a minimum claim amount of $10,000
  • for the last 12 months.

The results of this one-time report will be returned in one business day

Or order a customized report

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Select up to 20:
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Health - Paramedical Services
Acupuncture
Christian Science
Major Homeopathy
Major Occupational Therapy
Basic Dietician
Major Dietician
Major Orthotherapy
Chiropractor
Masseur
Physiotherapist
Psychologist
Psychiatrist
Speech Therapist
Miscellaneous Practitioner
Health - Hospital/Ambulance/Nursing Services
Basic Hospital
Major Hospital
Ambulance
Private Duty Nursing
Nursing Home
Health - Medical Services and Supplies
Miscellaneous
Basic Orthotics
Major Orthotics
Health - Out of Country
Emergency Out of Canada
Major Out of Canada
Referral Out of Country
Health Nursing / Vision
Hearing Aid
Vision Care
Basic Audiologist
Major Audiologist
Optometrist
Health - Miscellaneous
Drug
Dental Accident
Medical Doctor
Surgery
Diagnostic
Short Term Disability
Dental Services
Periodontic
Major Restorative
Basic Surgery
Major Surgery
Major Prosthetic
Orthodontic
Anaesthetic
Dental Services - Miscellaneous
Dental Miscellaneous
Tempro Mandibular Joint (TMJ)

Report frequency

Run One Time Only
Run one time only

Issue Date Range:

Choose the date range for the incurred claims:

What date do you want this report to run on?
Schedule a report to repeat regularly
Results by report frequency
Cumulative results

Notification Options

Yes   No 

Minimum claim amount

The minimum claim amount will cause the report to include only those certificates with claims equal to or exceeding the limit. For example, a $1,000 limit would exclude certificates with total claims of less than $1,000.

Run One Time Only

One-time reports are single report requests that are run once. Use a on-time report request for a "one-off" report that you do not need on a regular basis.

Schedule a report to repeat regularly

Repeated reports are reports run on a regular pre-defined frequency based on the plan's policy year. Use a repeated report request for a report that is required on a regular basis. For instance to track experience, identity trends or conduct divisonal or benefit analysis on a recurring basis.


Scheduled Report Options

The scheduled report option determines how the report results are accumulated:

  • Results by report frequency - the results are for the period of the report only. E.g. for the month or quarter only.
  • Results cumulative - the results are cumulative for the policy year-to-date, e.g. the second quarter report contains results from the first and second quarter.

Date range for incurred claims

In most cases, only a paid period is required. The incurral date field is an optional field used to determine liability for a claim; in cases involving a client or division termination, where claims incurred after the termination are the liability of the new insurer.

What date do you want this report to run on?

If you require a one-time report to be run on a future date, enter the date in this field. For example, you require a report run for a future period. Note that the run date must be later than the report period

Audience filter

  • External- all claimant details are removed from the report
  • Internal- for internal manulife use only, contains claimant information

Information on pooled health/dental claim listing reports

What does this report show?

Claim amounts that exceed the specified pooling limitfor either all services or selected services.

How can I use it?

What dollar amount you set for the pooling limit will determine which claims will be reported for the services you've chosen.

You could also use the report to capture indMdual daims over the limit that might affect the plan's experience.

Example:
  1. 1.Type in 10,000 forthe claim limit.
  2. 2. Select the following services - Emergency Out-of-Country, International Travel,Assistance (ITA), Major Out-of-Country, and Referral Out-of-Country
  3. 3. Choose the report frequency.
How are the pooled claims calculated for your report?

The claim limit specified in your report request checks against all of the records tied to a plan member, that is including any of the member's associated dependants. When any of a member's records exceeds the limit even ˇfit was just daims for a spouse all records tied to that member will display on the report.

Information health and/or dental claim summary reports

By procedure and relationship

What does this report show?

Claims by health service and dental procedure code, as well as by relationship (employee, spouse and dependants)

How can I use it?
  • Determine the utilization of the various services and procedures.
  • Identify claims for pooled services, such as out-of-country.
  • Identify the highutilization procedures, and how they are used by employees, spouses and dependants.

By procedure and month

What does this report show?

Claims by health service and dental procedure code, as well as/plus month the claims were paid.

How can I use it?
  • Determine the utilization of the services and procedures.
  • Identify claims for pooled services, such as out-of-country.
  • Identify the high-utilization procedures
  • Track claims utilization on a month-by-month basis.

Provincial Distribution

What does this report show?

Paid claims by benefit - health, dental and shortterm disability - and by province.

How can I use it?

This report can be used to determine the utilization of claims by province. Province is determined by the plan member's province of residence.

Plan sponsors who monitor benefit costs by location, can use this as the basis for determining the claims by province. Track claims utilization on a month-bymonth basis.