Insurance Billing Quick Reference
Provider contacts, BIN numbers, carrier IDs, and setup instructions for Canadian pharmacy insurance billing.
Blue Cross (ABBC)
Atlantic / Alberta Blue Cross & federal plans
Pacific Blue Cross (PBC)
BC-based carriers
Manitoba Blue Cross
Manitoba network
Saskatchewan Blue Cross
Saskatchewan network
NDC Health
National Drug Code network
NIHB
Non-Insured Health Benefits
Ontario Provincial
Ontario Health Network System
Cancer Agency
BC Cancer Agency direct billing
Complete Carrier Reference
All 36 carriers with BIN, network switch, carrier code, and help-desk phone. Also available as plain markdown for AI assistants.
| Carrier | BIN | Network | Carrier code | Phone |
|---|---|---|---|---|
| Canada Life (Great-West Life) | 600526 | NDC | 11 | 1-800-957-9777 |
| Sun Life Financial | 600526 | NDC | 16 / EP | 1-800-361-6212 |
| Manulife (ESI) | 610059 | NDC | 610059 | 1-800-268-6195 |
| Pacific Blue Cross | 610519 | PBC | PB | 1-888-275-4672 |
| Medavie Blue Cross | 610047 | ABBC | MC | 1-888-588-1212 |
| Green Shield Canada (GSC) | 610065 | NDC | G1 | 1-888-711-1119 |
| Desjardins Insurance | 600526 | NDC | 51 | 1-800-463-7890 |
| Industrial Alliance (iA Financial) | 600526 | NDC | 000060 | 1-800-463-6236 |
| NIHB (Non-Insured Health Benefits)First payer | 610068 | NDC | ESI | 1-800-580-0950 |
| ClaimSecure | 610019 | NDC | CS | 1-888-513-4464 |
| Equitable Life | 600526 | NDC | 29 | 1-800-265-8878 |
| Beneva (La Capitale) | 600526 | NDC | 62 | 1-888-423-6382 |
| Ontario Drug Benefit (ODB)First payer | N/A | Ontario HNS | ODB | 1-866-811-9893 |
| DVA / RCMP / DND (Veterans & Federal)First payer | 610047 | ABBC | 610047 | 1-888-588-1212 |
| IFHP / Refugee Claims (IFH)First payer | 610047 | ABBC | C1 | 1-888-614-1880 |
| First Nations Health Authority (FNHA)First payer | 610519 | PBC | E1 | 1-855-550-5454 |
| Alberta Blue Cross | 111111 | ABBC | 11 | 1-800-661-6995 |
| Manitoba Blue Cross | 610530 | MAN | 02 | 1-800-873-2583 |
| Saskatchewan Blue Cross | 611797 | SBC | 46 | 1-800-667-6853 |
| Manulife (NDC) | 610059 | NDC | 610059 | 1-800-268-6195 |
| Bigstone Band (NIHB)First payer | 610137 | NIHB | BS | 1-800-814-3684 |
| SSQ Insurance | 610074 | NDC | 610074 | 1-800-848-0158 |
| MDM (Maximum Benefit) | 601052 | NDC | 601052 | 1-800-267-6522 |
| Liberty Health | 610055 | NDC | 610055 | 1-800-268-5840 |
| Esorse (CATPA) | 610650 | NDC | 610650 | 1-800-268-9191 |
| Canadian Benefit Providers (CBP) | 610202 | NDC | 610202 | 1-800-665-5596 |
| NexgenRx | 610634 | NDC | 610634 | 1-844-639-4369 |
| DeltaWare | 610172 | NDC | 610172 | 1-800-565-5200 |
| Olympia Trust | 604647 | NDC | 604647 | 1-800-makeaclaim |
| BC Cancer AgencyFirst payer | N/A | CA billing | CA | 1-800-663-3333 |
| DVA (Veterans Affairs)First payer | 610047 | ABBC | V1 | — |
| RCMPFirst payer | 610047 | ABBC | R1 | — |
| DND (Department of National Defence)First payer | 610047 | ABBC | D1 | — |
| Worksafe BC (WCB)First payer | 600526 | NDC | 37 | — |
| Express Scripts Canada (ESI) | 610068 | NDC | ESI | — |
| TELUS Health / Assure | 600526 | NDC | TELUS | — |
Dependent Codes
Standard 2-digit codes appended to member IDs to identify the relationship to the cardholder.
| Code | Relationship |
|---|---|
| 00 | Cardholder (primary) |
| 01 | Spouse / Partner |
| 02 | Dependent child #1 |
| 03 | Dependent child #2 |
| 04 | Dependent child #3 |
| 05 | Dependent child #4 |
| 06 | Dependent child #5 |
| 07 | Dependent child #6 |
| 08 | Dependent child #7 |
| 09 | Dependent child #8 |
Pricing & Markup Notes
Standard Markup
Most private insurers accept the pharmacy's usual and customary (U&C) fee. Provincial plans (ODB, PharmaCare) have regulated dispensing fees and markups.
Lower-Cost Alternative (LCA)
Many plans reimburse only the lowest-cost generic equivalent. If the patient requests brand name, the difference is billed to the patient as a copay. Check the plan's LCA rules before dispensing.
Coordination of Benefits (COB)
When a patient has multiple plans, always bill the first payer (government/public plan) first. The balance is then submitted to the second payer (private plan). Government plans (ODB, NIHB, FNHA, DVA) are always first payer.
Compound Prescriptions
Most insurers require compound descriptor codes. Common codes: 1 = cream/ointment, 2 = capsule, 3 = solution, 4 = suppository, 5 = other. Check with the specific insurer for their compound billing requirements.
Frequently Asked Questions
Which BIN do I use for a TELUS Health claim?
TELUS Health network carriers in this guide bill through BIN 600526 — for example Canada Life (carrier 11), Sun Life (carrier 16) and Desjardins (carrier 51). Express Scripts Canada (ESI) plans use a different BIN, 610068. Always confirm the BIN printed on the patient's card before submitting.
How do I bill a patient who has two insurance plans?
Bill the first payer first, then submit the balance to the second payer. Government and public plans (NIHB, DVA, RCMP, DND, ODB, PharmaCare) are always the first payer. Private employer plans are billed second.
What dependent code do I enter for a spouse or child?
Append a 2-digit code to the member ID: 00 for the cardholder, 01 for a spouse or partner, and 02 through 09 for dependent children. GreenShield cards instead use a dash suffix on the ID itself (-00 primary, -01 spouse, -02 and up for dependents).
How do I bill a compound prescription?
Most insurers require a compound descriptor code with the claim: 1 for cream or ointment, 2 for capsule, 3 for solution, 4 for suppository, and 5 for other. Check the specific insurer's compound billing rules before dispensing.
What does lower-cost alternative (LCA) mean for reimbursement?
Many plans reimburse only the lowest-cost generic equivalent. If the patient requests the brand-name product, the price difference is billed to the patient as a copay. Check the plan's LCA rules before dispensing.
Is NIHB always the first payer?
Yes. NIHB (Non-Insured Health Benefits, billed through ESI with BIN 610068) is a government plan and must be billed before any private insurance. The same first-payer rule applies to DVA, RCMP, DND and provincial plans.
Sun Life lists two carriers — which one do I use?
Sun Life bills through TELUS as carrier 16 and through ESI as carrier EP (BIN 610068). Manulife is similar: ESI plans use BIN 610068 with carrier 02, while older non-ESI plans route through NDC with BIN 610059. Match the network printed on the patient's card.
Looking for a machine-readable copy? Use the markdown version of this guide.