We are excited to announce that you’ll be able to process pre-determinations (previously known as reserves) and claims for your Ministry of Social Development and Poverty Reduction (MSDPR) clients using PROVIDERnet as of March 12, 2021.

Automating manual processes allows you to submit most of your pre-determinations and claims 24 hours a day/ 7 days a week, reduces claims turnaround times, and enables you to get reimbursement directly into your bank account if you have direct deposit.

What does this mean to you?

• All claims for vision products and services submitted on behalf of MSDPR clients must have an approved pre-determination on file to secure eligibility and payment.
• Our Client Service Centre will no longer accept requests for call-in phone reserves. Instead, you can request pre-determinations using PROVIDERnet or you can mail/fax us a new, paper-based Vision form. If you fax/mail us this form, the outcome will be mailed to you.
• If you have registered for PROVIDERnet, you will also be able to view the outcomes online regardless of how the request was submitted.
• Pre-authorizations and claims that require supporting documentation will continue to be paper-based and can be submitted by fax or mail. The pre-authorization outcome will be mailed to you, and will also be available in PROVIDERnet.
• If you have a phone reserve on file for a client, it will expire 30 days after the March 12, 2021 go-live date. We encourage you to submit a pre-determination to replace these phone reserves as soon as possible after the go-live date, to ensure that the client’s services will be covered and that you can submit claims on their behalf. If you wish to claim using this phone reserve, you must submit a paper-based Vision form prior to April 12, 2021.
• No changes are being made to benefit coverage amounts for these clients, and fees will continue to be paid according to the MSDPR Optical Supplements Fee Schedule (although some fee codes will change to better identify service to right and left eyes).

Are you on PROVIDERnet yet?

If you’re already using PROVIDERnet for other clients, you’re set. However, if you registered a while ago and haven’t used it, we encourage you to log in and refamiliarize yourself with the system. Here is the quick start guide and vision reference guide to help you with navigation.

If you do not have a PROVIDERnet account, please register online today to ensure a smooth transition.

Here are some other things you should know:

• If you’re an optometrist that works in multiple stores, you will need to have a separate PROVIDERnet account for each location to process MSDPR pre-determinations and claims.
• If your optical store has an onsite optometrist, please ensure you have an optometrist provider ID for your store.

We’ll be publishing a new reference guide, a detailed FAQ, and a new Vision form on our Provider website, which will be available on March 12^th. These resources will provide step-by-step instructions on how to process MSDPR pre-determinations and claims.