• 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

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 approval(s)] are a simple way to check if a member for a benefit.

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

Please refer to the FNHA Mental Wellness and Counselling Benefit Schedule.

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.

Billing for services provided to clients who are not First Nations with Status are required to be    submitted by May 31, 2024. For questions, please contact at 1 855-550-5454 or email mhproviderreg@fnha.ca.

A Pay-Provider Authorization form (PPA) must be signed by the Client to process claim payments and to support audit requirements. By signing this form, Clients are authorizing registered mental health providers to direct bill Pacific Blue Cross on their behalf for the services provided. The provider must collect one signed PPA form per eligible Client, prior to the submission of a claim. This only needs to be completed once, and is valid for the period that the Client is receiving counselling services.

The Provider must collect a signed Proof of Services Rendered form for every counselling session.

The Pay-Provider Authorization form and the Proof of Services Rendered forms must be kept on file for a minimum of 7 years from the last date of claim submission on the Client’s behalf, and must be made available upon request. During the course of an audit, if a requested form is not available, the corresponding claim payment will be subject to review and possible adjustment.

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’s information cannot be retrieved with a status number, they are not enrolled. You will need to contact the FNHA.

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

Please note that FNHA Health Benefits will reimburse providers up to the maximum rates outlined in the Fee Supplement for services provided to eligible Clients. Please refer to the FNHA Mental Wellness and Counselling Benefit Schedule 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.