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Information for Health Providers

Provider Forms and Resources

Forms should be submitted according to the information or instructions listed on the form. If a form does not provide submission instructions, it can be faxed or mailed to First Nations Health Benefits.

For information about the transition of some benefits to Pacific Blue cross, see the PBC transition page.

 

Finance Forms

Direct Deposit Form

 

Forms for Dental Providers

Standard Dental Claim Form from the Canadian Dental Association

Partial Denture Trial Project Form - Dentists (GP/SP)

Partial Denture Trial Project Form - Denturists

 

Forms for Vision Care Providers

Eye Examination Prior Approval Form

Eyewear Prior Approval Form

Vision Care Provider Registration Form

Vision Care Framework and Fee Schedule

 

Forms for Mental Health Providers

Mental Health Provider Agreement Form

Mental Health Counselling Prior Approval Form

Mental Health Counselling Invoice Form

Guide to Mental Health Counselling Services

IRS Appointment Confirmation and Private Veh​icle Reimbursement Form (For IRS RHSP clients only)

 

Forms for Medical Supplies & Equipment Providers:

NIHB Medical Supplies and Equipment Claim Form

NIHB Hearing Aid and Hearing Aid Repair Prior Approval Form

NIHB General Medical Supplies and Equipment Prior Approval Form

NIHB Orthotics - Custom Footwear - Prosthetics - Pressure Garments Prior Approval Form

NIHB Oxygen and Respiratory Medical Supplies and Equipment Prior Approval Form

NIHB Medical Supplies and Equipment Claims Submission Kit

Modification to Pharmacy and Medical Supplies and Equipment Provider Information Form

Forms for Pharmacy Providers

These are a list of resources for pharmacy providers: Pharmacy Benefit Quick Links

Transitional Coverage Request Form permits a one-time fill per drug per patient, if appropriate. Pharmacists will be reimbursed $10 in addition to the usual drug cost plus dispensing.

Provider Relations

If you would like to contact First Nations Health Benefits with questions or comments about our program, contact Provider Relations at provider@fnha.ca.

If you would like to become a travel-in vision care provider, email visionproviderreg@fnha.ca.​

If you are looking to contact a First Nations band that provides vision care and/or mental health coverage independently through a Funding Agreement with the FNHA, click here.​

Registering as a Mental Health Provider

If you are a mental health provider and would like to deliver services to FNHA clients, please review the Guide to Mental Health Counselling Services. This guide outlines the terms and conditions, criteria, guidelines, and policies under which the First Nations Health Benefits Mental Health Program operates.  To register you will need to complete the Mental Health Provider Agreement Form.

To be eligible to provide services to FNHA clients, you must be currently registered with one of the following professional bodies:

 The BC Association of Clinical Counsellors

 The BC College of Social Workers

 The Canadian Counselling and Psychotherapy Association

​ The College of Psychologists of BC

If you are eligible to register with First Nations Health Benefits, please include all of the following in your registration package:

 Your completed Mental Health Provider Agreement Form.

 A description of your previous training and/or experience working with First Nations clients; or your certificate of completion for San'yas Indigenous Cultural Safety Training (Core Health or Mental Health)

 Verification of your current liability insurance (minimum $2,000,000 coverage)

​ For registers social workers and registered clinical social workers, a copy of Master's degree in a counselling related discipline

Please note that you will need to complete the San'yas Indigenous Cultural Safety Training (Core Health or Core Mental Health) run by the Provincial Health Services Authority. ​You will need to complete this within a year of your confirmation of registration with First Nations Health Benefits.

 How was your experience?

​We want to hear from you about your experience with FNHA Health Benefits. Please take 5-10 minutes to fill out our survey here:

​Fee​dback ​

​This client satisfaction survey will help us understand BC First Nations experiences accessing FNHA Health Benefits. We will use this information to improve the quality of our services.​​

Downlo​ad a print version of the FNHA Health Benefits Client Satisfaction Survey​

FNHA-Health-Benefits-Client-Satisfaction-Survey.jpg

Click here

​Client Satisfaction Survey FAQs

​Click here
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