To facilitate verification, all client identification information must be provided for each claim and request for pre-verification, predetermination and prior approval:
- Surname (under which the client is registered);
- Given names (under which the client is registered);
- Date of birth (dd/mm/yyyy); and
- Client identification number.
All Non-Insured Health Benefits (NIHB) claims, predeterminations and prior approvals are verified to ensure that client eligibility requirements are met. Claims, predeterminations and prior approvals with missing client identification information are returned to the provider for completion.
It is highly recommended that clients present their identification card on each visit to the provider to ensure that the client information is entered correctly and to protect against mistaken identity.
For infants under one year of age who do not have an acceptable client identification number, please refer to Special Provisions for Infants Under One Year of Age (Not applicable to dental benefits).
Client Identification Information:
A5. Client Identification Numbers for Eligible First Nations
Provision of one of these identifiers is required for eligible First Nations clients (including registered Indians under the terms of the Indian Act):
- INAC Number (also known as the Department of Indian Affairs of Northern Development (DIAND), Treaty or Status Number) - This is a 10-digit number issued by Indian and Northern Affairs Canada (INAC), formerly known as DIAND, to all eligible First Nations clients. The INAC number is the preferred method of identifying First Nations clients. This number is made up of:
- The first 3 digits identify the band to which the client belongs;
- The next 5 digits identify the client's family unit within the band; and
- The last 2 digits identify the client's position in the family (for example, 01, 02, and 03).
- Band Number and Family Number - If an INAC number is not available, a band name or number and family number may also be used as client identification.
- First Nations Inuit Health Branch (FNIHB) Client Identification Number (B-Number) - In specific and exceptional cases, some clients may have numbers issued by FNIHB. This number begins with the letter "B" and is followed by 8 digits.
A6. Client Identification Numbers for Recognized Inuit
Providing one of these identifiers is required for recognized Inuit clients:
- Government of the Northwest Territories (GNWT) Health Care Number - Inuit clients from the Northwest Territories may present a Health Care Number issued by the Government of the Northwest Territories. This number is valid in any region of Canada and is cross-referenced to the FNIHB client identification number. This number begins with the letter "T" and is followed by 7 digits.
- Health Care Number - Inuit clients from Nunavut may present a Health Care Number issued by the Government of Nunavut. This number is valid in any region of Canada and is cross-referenced to the FNIHB client identification number. This is a 9-digit number starting with a "1" and ending with a "5".
- FNIHB Client Identification Number (N-Number) - This is a client identification number issued by FNIHB to recognized Inuit clients. This number begins with the letter "N" and is followed by 8 digits.
A7. Neonatal Clients (Dental)
For dental services only, providers must contact the appropriate FNIHB Regional Office for neonatal clients.
A8. Special Provisions for Infants Under One Year of Age (Not applicable to dental benefits)
Health Canada established special client identification provisions for infants less than one year of age. These provisions are in place to allow adequate time for parents eligible for benefits under the NIHB Program to register their newborn children on the appropriate register (for eligible First Nations clients) or list (for recognized Inuit clients).
A8.1 To register an infant:
- For eligible First Nations clients, parents should be referred to their Band Office or the Registration Services Unit of the Department of Indian and Northern Affairs Canada (INAC) at (819) 953-0960;
- For Inuit residing in the Northwest Territories and Nunavut, parents should be referred to their respective territorial Department of Health and Social Services; and
- For Inuit residing outside of the Northwest Territories and Nunavut, parents should be referred to the nearest FNIHB Regional Office.
Infants under one year of age who do not have an acceptable client identification number may be eligible to receive benefits from the NIHB Program if one of the infant's parents can be verified as an eligible client (not applicable to dental benefits).
If a client identification number is not available for infants under one year of age, this information must be provided to receive benefits:
- Infant's surname, given names, and date of birth; and
- Parent's registered surname, given names, and date of birth and client identification number.
Note: To avoid benefit access rejection, parents must obtain a client identification number for the infant prior to the infant's first birthday.
Providers may verify client eligibility in advance of providing services by contacting the Non-Insured Health Benefits Toll-Free Inquiry Centre.
The mandate of the NIHB Program is to provide non-insured health benefits to eligible clients in a manner that facilitates First Nations and Inuit control within a timeframe to be determined in consultation with them. This is currently being tested under several agreements with First Nations and Inuit organizations.
Providers are notified, through the quarterly NIHB Newsletters when individual First Nations or Inuit organizations assume responsibility for the delivery of the NIHB Program. At that time, members of those groups receive benefits through their First Nations or Inuit organizations rather than through the NIHB Program. Providers are directed to the appropriate First Nations or Inuit organizations for further information.
These First Nations/Inuit Organizations have assumed responsibility for the delivery of pharmacy, MS&E and dental benefits:
- Akwesasne Band #159
- Bigstone Cree Nation #458
- Nunatsiavut Government (formerly the Labrador Inuit Health Commission)
- Nisga'a Valley Health Board
- Gingolx (Kincolith) #671
- Gitakdamix (New Aiyanish) #677
- Lakalzap (Greenville) #678
- Gitwinksilkw (Canyon City) #679
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