Service Contracts
The AOA is committed to providing health services to those in need
There are different rules for billing and claiming health services for different people in Canada. The AOA has contracts with several health service programs to make it easier for some groups to claim their eye care costs.
You will find information about the different programs, and links to further information in the sections below. The contracts are negotiated by Rick Miller, Chair of the Negotiations Committee.
Alberta Blue Cross
The ACAO has contracts with Alberta Blue Cross to provide health services to various groups of people.
The Alberta Blue Cross website has a list of groups that receive health benefits. It also has instructions on the billing time-frame.
Many of the groups that receive health benefits from the Government of Canada partner with Medavie Blue Cross to provide a direct billing option.
Opting Out
Balancing financial obligations with financial relief
As much as we would love for every optician to be in a position to offer these services at every location, the reality is that sometimes it’s not possible. We know that it can be especially hard for smaller businesses and independent stores to make ends meet when the contract doesn’t cover the extra expense on some jobs.
While we encourage you to participate in these programs, if you find that you need to opt out, you should inform the contractor in writing that you will be unable to participate in ANY part of the contract; this is in the interest of fairness.
You can’t agree to do the simpler jobs and refuse the harder, more expensive ones, because it is inequitable to those patients who require extra care.
You may also discuss these issues with the negotiations committee chair. The negotiations committee chair works with the contracts and points out any issue of disparity to the payers.
We hope that future contracts will be able to cover the full cost of everything their patients need. In the meantime, we encourage you to participate, if possible, for the sake of those who rely on these programs to receive proper care.
Alberta Human Services
The Alberta Human Services Contract and Fee Schedule is effective July 1st, 2020. This contract covers “Independence, AISH, Children’s Services and Child Health Benefits.”
Alberta Human Services recently split into two ministries, “Community and Social Services” and “Children’s Services.” We will update this section as we receive more information.
Non-Insured Health Benefits (NIHB)
Health services for our nation’s first peoples
The Non-Insured Health Benefits (NIHB) program provides eligible First Nations and Inuit clients with coverage for a range of health benefits that are not covered through other social programs, private insurance plans, or provincial or territorial health insurance.
For more information about the Non-Insured Health Benefits program, visit the First Nations and Inuit Health Branch page on the Health Canada website. To view the NIHB Vision Care Provider Agreement, click here.
For NIHB health provider information including provider registration and claim processing procedures, visit the Health Provider Information page. The procedures for submitting an NIHB claim are outlined on the Express
Scripts Canada Non-Insured Health Benefits Claims Services Provider Web site (www.provider.esicanada.ca). The site also contains claim forms, newsletters, fee schedules and much more.
For NIHB contact information, click here.
Veterans Affairs
For those who served our country
Veterans Affairs Canada partners with Medavie Blue Cross to give health benefits to Veterans, and the ACAO has a contract to bill them directly for eye care services.
The Veterans affairs website says: “For most benefits, your provider will need your signature to confirm that you received their services. It is important that you only sign after you have received the service.” Veterans should have their VAC health card with them.
Royal Canadian Mounted Police (RCMP)
For those who continue to serve
The RCMP has a national health benefits plan that may supplement their provincial plans. Our contract allows you to bill qualifying members’ eye care services through Medavie Blue Cross.
The national health benefits plan covers public service pensioners, too. So, some retired RCMP officers and their families may also qualify.
Interim Federal Health Program (IFHP)
For those new to our country
The ACAO has a contract with Medavie Blue Cross for the Interim Federal Health Program (IFHP). Some recent immigrants and refugees qualify for IFHP relief, including eye care services.
The IFHP website recommends that before providing services, you verify that your patient is covered every time you see them. The IFHP is a temporary program, and a patient may no longer be eligible since their last visit. You will not be able to bill for any services provided for those no longer covered under the IFHP.