Adjudication Services

Express Scripts Canada provides a comprehensive range of services that enable health-care providers to determine an insurer's payment or financial responsibility, after the member's insurance benefits are applied to a medical claim.

Since 1996, insurance carriers, third-party benefits administrators and the public sector have partnered with Express Scripts Canada to handle their health-insurance claims adjudication process needs. Express Scripts Canada’s adjudication expertise and depth of knowledge makes it possible to provide clients with quantifiable gains in quality and operational efficiency with faster turnaround.

Express Scripts Canada’s leadership and proven capabilities in the health-claims adjudication market has resulted in long-term working relationships with many companies which themselves hold leadership positions in their respective sectors of the health-benefits industry. Express Scripts Canada continues to raise the bar, working closely with its clients to develop processes and solutions to address their current and emerging needs – in particular, processes involving dental claims and pharmacy claims adjudication.