Express Scripts Canada

Home

About

NIHB Medical Supplies and Equipment Provider Documentation

Registration

Instructions

To register in the Medical Supplies and Equipment (MS&E) NIHB Program:

1.	Download the Medical Supplies and Equipment Provider Agreement: Medical Supplies and Equipment Provider Agreement Sample Copy of a completed Medical Supplies and Equipment Provider Agreement: Medical Supplies and Equipment Provider Agreement (Completed Sample)
2.	Complete the Medical Supplies and Equipment Provider Agreement fully for all required sections.
	Did you know…
	Electronic Funds Transfer (EFT) is free and secure?
	Sign up by completing the Payment Information section of the Medical Supplies and Equipment Provider Agreement and eliminate mail delivery delays of lost, misplaced, or stolen cheques! Receive your claim payments directly into your designated bank account on the day the payment is issued and still continue to receive mailed statements for reconciliation!
3.	Sign the Medical Supplies and Equipment Provider Agreement (where indicated).
4.	Fax all pages (including a photo copy of a VOID cheque or official bank letter for EFT payments) of the Medical Supplies and Equipment Provider Agreement to Express Scripts Canada at fax number 1-855-622-0669.

MS&E Forms

Claim

NIHB Medical Supplies and Equipment Claim Form

Prior Approval and Confirmation Letters

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

Claims Submission Kit

NIHB Medical Supplies and Equipment Claims Submission Kit

NIHB Medical Supplies and Equipment Claims Submission Kit Attachments

Provider Information Changes

Modification to Pharmacy and Medical Supplies and Equipment Provider Information Form

Contacts

Express Scripts Canada Provider Claims Processing Call Centre

Extended Hours of Operation:		Monday to Friday 6:30 a.m. - 8:30 p.m. ET, excluding Statutory Holidays

Telephone Inquiries:		1-888-511-4666

Mail:		For MS&E claims, mail to:
		Express Scripts Canada NIHB MS&E Claims P.O. Box 1365, Station K Toronto, ON M4P 3J4

		For all other correspondence, mail to:
		Express Scripts Canada 5770 Hurontario St., 10th Floor Mississauga, ON L5R 3G5

Health Canada

Click Health Canada Contacts to view all the NIHB Program contact numbers.