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Agreement reached with CUPE 1816

On Sunday, September 10, Pacific Blue Cross and our union represented by CUPE 1816 ratified a new collective agreement.  We are pleased to turn the page on this chapter in our history and return to full service capacity.
On behalf of our entire organization, I express my sincere gratitude to our Plan Sponsors and Advisors for your patience and understanding over these past weeks.  
We have a plan for resumption of service when our union employees begin returning to work on September 18.  As an organization, we will now be focused on returning to full operation over the next few weeks, with a priority on addressing the current claims backlog.  We are working to assess this plan and timing for our Return To Work (RTW) Plan.  We will communicate the specifics of our RTW Plan shortly.
In the meantime, we ask you to continue to remind your Members to use our online and Insta-Claim services for fastest payment. 
Members can use their Pacific Blue Cross Member ID cards to claim online.   
  • Direct pay at pharmacies: If your plan allows pay direct drugs, Members can show their Pacific Blue Cross Member cards at 100% of pharmacies for instant reimbursement.
  • Insta-claim: Members can show their cards at more than 6,600 Provider locations in British Columbia for claims processing on the spot.
  • eClaims: Members can sign in at or use our mobile app to submit claims for most health services and prescription drugs. Reimbursement is in as little as 48 hours.
For Members who have submitted paper claims
  • We are making plans to increase our paper claims processing capacity.
  • Throughout the service disruption, we have been prioritizing all claims in order of date received and highest cost.
  • We’ve already started processing paper-based claims over a certain dollar threshold, including pre-authorizations and assignment of payment requests.
  • Please note there is no need for Plan members to re-submit paper claims as this will not expedite claims processing
Members can check claim status in CARESnet.
We anticipate a very high volume of calls from Members and Providers with claims inquiries, when service resumes next week.
If your plan allows access to our online services, Members can use CARESnet to check if a claim or pre-authorization has been processed faster than by phone:
  • Members can sign in at using the numbers on their Pacific Blue Cross Member ID cards.
  • If nothing is posted to the account, it means the claim is still being processed. 
  • Members who are waiting on paper claims may still re-submit them online until further notice. This will be faster than by mail, and our system will reverse any duplicate claims.
Our service commitment to you.
During the disruption, your Pacific Blue Cross Account Executives were deployed to other service areas including our walk-in centre, mailroom and claims processing departments.  They will begin to return to their regular routines after September 18. 
We can all agree that we have learned a great deal over the past 6 weeks. We have uncovered many opportunities to improve processes to serve our Plan Sponsors and Members better and faster. This includes reducing paper handling times, removing unnecessary administrative processes and adding more online and Insta-Claim options.
I give my personal commitment to you that Pacific Blue Cross will not only live up to our reputation as BC’s #1 health benefits provider, we will exceed it.

With warmest regards,
Jan K. Grude
Jan K. Grude
President and Chief Executive Officer

Blue Shield

Blue Shield is a registered trade-mark of Blue Cross Blue Shield Association