1. World Access FAQ Session
Presented To:
University of Windsor

2. Agenda Who is World Access Assistance Procedure Claims Procedure Tips
Questions
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

3. World Access Corporate Structure
NYSE “AZ”
Paris, France
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

4. Canadian Operations
World Access Canada

5. Canadian Operations (World Access Canada)
24/7/365 Kitchener, Ontario
Approx 250+ employees
50 experienced claim adjusters
15 medical case management nurses
Multilingual response – 17 languages
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

6. Green Shield Member Services
Pre-trip assistance
Emergency Medical Assistance
Emergency Message Centre
Emergency Cash Transfer
Emergency Legal Referral
Lost Document Assistance
Emergency Translation Services
Medical Case Management
Emergency Evacuation
Cashless Medical Services
Claims Payment
Recovery – GHIP submission
Co-ordination of Benefits
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

7. Member Cases Member calls WA – needing to seek treatment
WA offers referral
WA makes billing arrangements with provider
WA medically monitors case – approval for any investigative/invasive treatment
WA assists member to get back to Canada if necessary/appropriate
Claims come directly to WA – negotiated and paid
GHIP Recovery done by WA
Coordination with other insurance done by WA
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

8. Pre-trip and Emergency
Assistance Services
Pre-trip and Emergency

9. Pre-Trip Preparation
Pack your Green Shield wallet card with the World Access Emergency phone number on it and your WAC booklet
WAC booklet can be downloaded by visiting: - then by choosing “Benefits”
If you will be travelling outside of North America call World Access for the international dialing codes required to call Canada from your destination
Inquire if there any Canadian Travel Advisory’s for your destination Country
Ask any benefit questions prior to leaving
To confirm coverage you need to verify with Green Shield directly
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

10. Medical Emergency Evaluate your emergency
If immediate medical assistance is needed then call for an ambulance (911 where applicable)
Once at the hospital call World Access to open a case or have a family member call on your behalf
If immediate attention isn’t needed call World Access to open a case prior to seeking medical treatment
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

11. Why contact World Access?
Assist in finding an appropriate level of medical care – clinic, hospital
When possible World Access will arrange billing prior to your visit
Able to inform clinic/hospital you are coming in prior to visit
Provided a case number to reference your emergency
Medically manage the case to ensure procedures and practices are eligible for coverage
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

12. One City in Africa, Two Hospitals
Hospital A
Hospital B
Thanks to thorough provider credentialing, World Access knows to choose Hospital B.
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

13. Case Opening 10-15 minutes to open
Requires full details (OHIP number, Green Shield Number, date of birth, contact numbers, etc)
Privacy statements will be advised
Investigative and Intrusive Procedures must be approved in advance
World Access will monitor your case with hospital staff to ensure procedures are eligible
Call or to open a case
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

14. Claims Procedure

15. Submitting Claims Claim forms will be sent to home address
Advise if you wish them sent elsewhere at case opening
Forms available on the Green Shield Website
Submit claim forms, medical documents and all original bills to World Access
Keep copies of the bills for yourself
Mail forms to P.O Box 277, Waterloo, N2J 4A4
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

16. Inquiries Regarding Your Claim
Call
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

17. Claim Submission Tips
Delays occur when further documents or information is needed
3 most common delays: claim forms, medical records, improper bills
If you are in a hospital obtain a discharge summary before leaving if possible
Requirements from the Canadian Government for reimbursement:
Original Itemized Bills
HCFA or UB92 bill if in USA
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

18. When a Claim is Processed
World Access will negotiate the bill with the provider to obtain preferred rates
If payment of the claims are outstanding cheques will be issued directly to the provider
You will receive an Explanation of Benefits advising of any discounts and total payment issued.
If you have paid the claim payment will be issued by cheque to your home address
Proof of payment should be submitted to World Access with your claim
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

19. Received Partial Reimbursement
Items may not have been covered under the policy
Items might have been covered under your regular Green Shield Plan and forwarded to Green Shield directly for processing (ex. Extended Healthcare Benefits)
Some bills processed while others still awaiting documentation (ex. Proper bills)
Questions call
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

20. Received a Bill from a Collection Agency?
Billing departments are not always located within the medical facility
Payment issued but reminder invoice sent before reaching billing service
Bill may have never been submitted to World Access
Verify amount of bill to your Explanation of benefits
Call immediately
World Access will contact the collection agency and provider to rectify the situation
This document and its contents are confidential and cannot be disclosed to any other party without permission of World Access.

21. Questions?

22. Adjournment
Thank you for your time.