Members - Digital Submission Process

Architype Benefits has Online Claims Submisson Process

• Employees can make claims on their health and dental plan
• Plan Administrators can make changes to the company plan

Architype Benefits now has the ability to accept claims from employees through a digital submission process. Employees can now download a claims form for their plan, fill it in online, and email it to us along with a photo or scan of their various receipts.

Claims can be emailed to benefits@ArchitypeBenefits.ca

1. Claim forms and receipts need to be received in MS Word, PDF, or JPG formats.
2. Our claim form for Extended Health claims is required with all claims submitted. The standard Dental Claim Form is still the one you normally get from your dentist. (Note, the dentist’s statement or invoice is not acceptable as a claim form.) Both of these forms are available .
3. Receipts should be scanned and emailed with your claim form, or you can use your cell phone to take a photo of receipts and email that together with the claim form. They need to be readable.
4. Claim forms and receipts must be together in the same email. Otherwise we can’t be sure which receipt goes with which claim.
5. Large claims over $750 in total claim amount need to be sent through the old, normal, snail-mail process. These will all be adjudicated just as they always have been.
6. Claims will be randomly audited at different points during the year. We will identify the claims to be audited, and advise employees that certain specified claims are being reviewed. Please ensure you keep your original records and receipts in the case your file is selected for review. All original documents submitted will be retained by Architype Benefits as they normally are now.
7. Requested records that are received incomplete, with questionable documentation, or are late, will be flagged as “Failed Claims Audits” and claims payment may be reversed at Architype Benefits. This means a payout will be reversed on the employee account, and future claims payments will be subject to a deduction of the failed audit claim amount.
   a. All future clams at that point may also be required in original copy by mail – the old way.
   b. Employees will of course have the right to request a review of the audit and try to sort things out.