This PIA is an addendum to document the process change for the Seniors Pharmacare application and gathering of dental data from Medigent and submitting the data to Pacific Blue Cross for processing of dental claims.
Currently, the Pharmacare and Extended Health Benefits Application Forms are processed through the Medigent Claims Processing System by the Pharmacare Dental Officer (PDO). PDO are employees of HSS. Claims are received from the dental office or the pharmacare beneficiary and verified to be eligible in Medigent. Claims are then processed and paid by the Insured Health Finance department.
Moving forward, the Pharmacare and Extended Health Benefits Application Form will continue to be processed through Medigent for the Extended Health Benefits, however all eligible applicants will now be registered with Pacific Blue Cross (PBC) for their Dental Benefits and dental claims will be billed through PBC directly.
