A-29, r. 3 - Regulation respecting insured visual aids and related services

Section 44.1 Disposition versions

2012-09-01

44.1. The Board is to reimburse to a recognized institution the purchase, replacement or repair cost of a visual aid, its components or supplements, only if the institution sends to the Board a statement of account, using a form provided by the Board, including the following information, which may vary according to the medium used, whether the visual aid is marked “SC” or a claim for payment is made:

(1)  the health insurance number, the expiration date indicated on the health insurance card and the information required by the Board to identify the insured person who benefited from the property or service;

(2)  the institution’s name, permit number, dispenser number, the reference number of an application for a visual aid marked “SC” or a claim for payment and, in the case of a transfer, the number of the transferred device and the name and permit number of the institution where the device was transferred;

(3)  an indication relating to the visual acuity and the field of vision in each eye, the qualification of visual incapacity, a description of the pursuit of activities justifying the allocation of a visual aid and, where the purchase or replacement cost of a visual aid is marked “SC”, the information referred to in this Regulation;

(4)  the code of the property or service, its nature, justification, the number of the device, the amount claimed and the date on which the property was allocated or the service rendered;

(5)  a statement by the insured person confirming that the person received the property or service described and authorizing the Board to make the payment; and

(6)  a statement by the person in charge of the institution that the information given is accurate and complete.

O.C. 1091-2011, s. 2.