• Easy to use and secure
• Reduced reimbursement time
• Faster turnaround for pre-determinations
• Convenience of real-time submission
• Able to see results immediately
• View pre-determinations and claims in one place
• Client convenience and satisfaction
• Reduced administrative burden
• View Fee Supplement

PROVIDERnet allows you to submit pre-determinations and electronic claims on behalf of your clients. The system is real-time and provides you with immediate claim results.

• Registered Clinical Counsellors**
• Certified Clinical Counsellors**
• Registered Social Workers** or Registered Clinical Social Workers**
• Psychologists

** Practitioners must be registered with their regulatory/licensing body in BC and approved by the FNHA.

• Mental Wellness and Counselling Programs
• Missing and Murdered Indigenous Women and Girls Health Support Services Program
• Indian Residential Schools Resolution Health Support Program
• Indian Day School Health Support Services Program

Online registration takes about three minutes for one practitioner. If you have multiple practitioners in your office, it may take longer. Once processed, you will receive an email confirmation with login information.

The provider office is the brick and mortar store for your business, i.e. ABC Counselling Clinic or 123 Psychology Centre.

The practitioner is the person who provides the service, i.e. Dr. John Smith, Certified Clinical Counsellor.

This individual can be the practitioner, front desk individual or office manager who works in the clinic. This individual is responsible for setting up direct deposit and submitting the electronic claims for themselves (practitioner) or on behalf of the clinic (front desk/office manager).

The primary administrator is the only person who can view and download claim statements and MUST have a separate email address from the practitioner.

Yes. The email address for the primary administrator may be the same as the provider office email; however, the practitioner email must be different.

Use your primary email address as the provider office email. For the practitioner email address in Step 2 of the registration process, use a fake email address in the format of firstnamelastname@email.com (i.e patsmith@email.com) in order to complete your PROVIDERnet registration. Your application will be processed normally and we only need your provider office email when you use PROVIDERnet in the future.

An email will be sent with the reason for the decline.

Pre-determinations (previously known as prior approvals) are a simple way to check what programs a member qualifies for.

Yes. Providers must have an approved pre-determination before delivering services for the claim to be eligible for payment.

Refer to the Health Provider Reference Guide for more information.

Pre-determinations that were approved prior to the transition were transferred into PROVIDERnet. Please sign into PROVIDERnet and view your Authorized Products and Services to view your previously approved pre-determinations.

You will not receive a direct notification like an email. You will be sent an EOB statement by mail, or you can use PROVIDERnet to search for the pre-determination for the individual and check the status. It will change from Pending to Approved.

This information can be found in the Health Provider Reference Guide. Providers would contact FNHA at 1-855-550-5454 and provide the client’s information. Once reviewed by FNHA, you will receive an email with your clients Member ID. When you have the Member ID you will be able to submit via PROVIDERnet.

Providers are required to capture client signatures in the following two scenarios:

1. Pre-determination. The Pay Provider Authorization (PPA) form is required for ALL clients, but only needs to be signed ONCE.
   1. For new clients: Providers should get the client’s signature on the PPA before submitting the first pre-determination to Pacific Blue Cross.
   2. For existing clients: Providers should get the client’s signature at their next session.
2. In-person sessions. For each in-person session, a provider can use their own form as long as it captures the client’s name, date and duration of the session, and client signature. Alternatively, FNHA is developing a Proof of Services Rendered form, which will be available very soon. These forms should be maintained by the provider and only submitted to FNHA upon request.

Read out the PPA Verbal Consent to the client and enter your full name, method of session (i.e. video or phone), and date. Send the client a blank copy of the PPA via email or mail to sign. Once returned, keep both copies of the PPA on file. It is important to read out the verbal consent as detailed.

Read out the PPA Verbal Consent to the client and enter your full name and method of session (i.e. video or phone) on the Pay Provider Authorization form.

PROVIDERnet will provide you with the number of hours remaining on a pre-determination when submitting a claim that is APPROVED for the FNHA Client.  This can be found by reviewing the Response Message (C4822) attached to the claim.

Please submit a pre-determination through PROVIDERnet for the client you are seeking an extension for.

For a provider to submit a pre-determination / claim on behalf of an FNHA client, the client needs to be enrolled under the FNHA policy.  When submitting a pre-determination/claim and the individual cannot be retrieved with an ID / status number, they are not enrolled.  You will need to contact FNHA.

Services are available for survivors, family members, and others affected by the issue of missing and murdered Indigenous women and girls in Canada. First Nations and non-First Nations individuals may be eligible for the program. ​

Please complete the pre-determination based on the information provided by the client. If the client does not know, then leave it blank.

Yes. PROVIDERnet is real time so the claim (previously known as invoice) is adjudicated and results are shown immediately.

We recommend submitting the claim while the client is in your office, at the time the service is provided. You have up to one year from the date of service to submit a claim. Coverage must be active to be eligible for payment.

Refer to the Health Provider Reference Guide for more information.

This issue has now been resolved. Please try to resubmit your claims.

Please review the expense types. It would depend whether this was a group session with both the child and parent present, or if this was two individual sessions. If the latter, then the parent would need to have their own pre-determination approved and the claim processed under their individual file.

A GST number is required for providers that charge GST.

A weekly email will be sent to the provider office email address when the claim statements are ready. Only the primary administrator can view and download claim statements.

Payments are made weekly through direct deposit into your business bank account if you have set up direct deposit in PROVIDERnet. Your bank may take up to three business days to deposit the payment into your account.