Tips for Finding the Right Provider
Using Your Benefits
In addition to finding a service provider (think massage therapist, medical supply provider, etc.) you personally connect with, there are numerous other factors you must consider before purchasing a product or receiving a service. Check out our top three tips below for finding the right provider, including the ins-and-outs of our Ineligible Providers feature on My ASEBP.
Before you commit to any product or service, a big question on your mind may be: is it covered? Fortunately, we have a few easy ways you can get the answers you’re looking for:
- asebp.ca – That’s right! Our public website is a great resource for general coverage information. All you have to do is navigate to Benefits and select the category you’re looking for. From there, our What’s covered? and What’s not covered? sections have got you…well, covered.
- My ASEBP – If you really want to dig into your specific benefits, our covered member portal is the place. Under the Benefits menu, you’ll find:
- the specific plans you’re enrolled in (see My Benefits)
- the exact dollar amount you have remaining for our most popular services (see Usage Summary)
- your spending account balances (see Spending Account Activity)
- whether a specific drug (see Drug Inquiry) is covered and to what amount
ASEBP’s committed to protecting its benefit plans from misuse and abuse so we can ensure the long-term sustainability and good financial health of the plan. As a result, occasionally, there’s a need to deem certain service providers as ineligible due to non-compliance with claiming or audit standards. When a provider is deemed ineligible, this means that claims submitted for services or products they’ve provided won’t be reimbursed by ASEBP’s general health benefits (e.g. drug, dental, vision, etc.).
In the past, ASEBP has accepted the first claim from an ineligible provider as a way to let you know that they’ve been deemed ineligible and that future claims from them will be declined. However, as of Monday, November 28, 2022, this will no longer be the case. Moving forward, we encourage you to use My ASEBP’s Ineligible Providers tool (found under the Providers menu) to determine which providers are ineligible to avoid paying out of pocket for a product or service. This look-up tool allows you to search by provider name, clinic, and/or location to determine eligibility status. Additionally, if a provider you’ve visited in the past 12 months, which resulted in a claim to your ASEBP benefits, is later deemed ineligible, you’ll receive an email from ASEBP letting you know about their change in status. Note: you must be registered for My ASEBP to receive these email notifications.
Location can make a huge difference in the provider you choose to visit. Whether you’re looking for a provider near your home, workplace, or anywhere in between, our Service Providers tool (found under the Providers menu) can help. Available since 2019, this tool has been helping covered members across Alberta:
- see how close a provider is to them
- find out which providers offer direct billing
- see what peers (other covered members) think of them
- recommend service providers they've visited
With our digital tools in hand and your newfound knowledge, you can ensure you’re doing your due diligence in finding the right service provider. And remember, that while ASEBP won’t pay claims incurred from ineligible providers, this doesn’t mean you can’t use them—you’ll simply have to pay out of pocket. If you have questions about your coverage or ineligible providers, feel free to reach out to us.