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To register, download the MS&E Provider Agreement, complete all required sections, sign the Agreement, and return by fax to ESI Canada:
Fax No.: 905-712-0669
For further information, contact the Provider Claims Processing Call Centre:
Phone No.: 1-888-511-4666
Monday to Friday:
6:30 a.m. to 8:30 p.m. Eastern Time, excluding Statutory Holidays
FULL SET OF ALL REGISTRATION FORMS FOR MS&E PROVIDERS
NIHB Medical Supplies and Equipment Claims Submission Kit
NIHB Medical Supplies and Equipment Claims Submission Kit Attachments
ESI Canada Medical Supplies and Equipment Provider Agreement
ESI Canada Medical Supplies and Equipment Provider Agreement (Sample)
NIHB Medical Supplies and Equipment Claim Form
Provider Statement - Medical Supplies and Equipment (Sample)
Prior Approval Confirmation Letter (Sample)
ESI Canada Modification to Pharmacy - Medical Supplies and Equipment (MS&E) Information Form
NIHB Hearing Aid and Hearing Aid Repair Confirmation 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
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