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Submit claims to Desjardins

Note: You'll need to create a Desjardins plan member account before you can submit a claim. Learn how to create a Desjardins Group insurance account.

This article will review how to:

  • Check if you have coverage from Desjardins

  • Submit insurance claims online through web or mobile

  • View claims status

  • Submit paper claims

Getting Started

Checking for Desjardins coverage

To check if your employer has Desjardins benefits through League, navigate to your League Wallet. You'll see a list of benefits. Clicking or tapping on a benefit will reveal more information. If you have Desjardins coverage, you'll see one or more benefit cards containing a Desjardins insurance logo:

desjardins security card

For more information on your Desjardins policy, please refer to your Desjardins benefits booklet. This can be found in the League platform by:

  1. Selecting a Desjardins benefit.

  2. Navigating to “Actions”.

  3. Selecting “Full Coverage Booklet”. 

You can also access your booklet by contacting your employer, chatting directly to our Customer Care team through League in the "Chat" tab, or by sending an email to help@league.com

When to submit claims to Desjardins

Desjardins is your insurance provider through your League benefits and: 

  • If Desjardins is your primary insurer, all eligible insurance claims must be submitted to them first

  • Once Desjardins adjudicates your claim or makes a payment for an eligible item/service, you can "coordinate benefits " by submitting remaining expenses to any other insurance providers (such as your spouse's insurance coverage, etc).

  • If you have supplementary benefits with League, such as a Health or Lifestyle Spending Account, you can submit claims to League after all other forms of insurance have been applied . This helps maximize your coverage.

When you have Desjardins coverage, you'll have one or more of the following benefit cards in your Wallet:

Drug

  • Should be directly paid by Desjardins at the pharmacy counter

  • Show the pharmacist your electronic Drug card in your League Wallet

  • If you weren't able to pay directly with your Drug insurance,
    submit the claim to Desjardins directly

Dental

  • May be directly paid by Desjardins at the Dental reception

  • Show the receptionist your electronic Dental card in your League Wallet

  • If the Dental office doesn't offer direct billing and you weren't able
    to pay direct, submit the claim to Desjardins directly

  • Check if your dentist offers direct billing.

Paramedical Services

Medical Services & Supplies

  • Often can’t be paid directly by Desjardins

  • You may have to pay out-of-pocket and then submit the claim to Desjardins

Vision

  • May be directly paid by Desjardins at reception

  • Show the receptionist your electronic Vision card in your League Wallet

  • If the office doesn't offer direct billing and you weren't able
    to pay direct, submit the claim to Desjardins directly

  • Check if your doctor offers direct billing.

For all other claim types, select the benefit that best describes the type of expense and follow the instructions under the "Overview" section. 

Submitting claims to Desjardins

With Desjardins' plan member portal, you’re able to:

  • Submit claims electronically

  • Check claims status

  • Monitor your benefits coverage balances

  • Set up direct deposit for claim payments

To submit claims on the Desjardins plan member portal, log in to your account:

You can also access the web login page through your League account. Simply sign in to League > Navigate to your Digital Wallet > Select any of your Desjardins benefits > Click "Submit Claim via Desjardins".

 

On web

1. Enter your User ID and password. 

Note: If you haven't registered for Desjardins yet, see Create a Desjardins Group Insurance account.

2. Click “Confirm”. 

You’ll now be logged in to your Desjardins plan member account.

desjardins webpage log in screen with user id field, password field and confirm button highlighted

3. Click the “Submit a claim” tab.

4. Select either:

  • Online Claim (Continue to Step 5)

  • Paper Claim (Continue to Paper Claims section at the end of this article)

desjardins insurance webpage with submit a claim button a claim options highlighted

5. Read the Conditions of Use and click “I Accept” or “I Refuse”.

Note: Desjardins provides useful information on what professionals are eligible for submitting claims online, to the right of this page.

desjardins online claim webpage with accept and refuse buttons highlighted

6. Select the name of the patient who received the service or treatment from the “Patient” drop-down menu.

7. Select the provider who provided the service or treatment from the “Provider” drop-down menu. 

Note: If the provider isn’t on the list, click “Add/Edit” and fill out their information.

8. Fill out the following sections:

  • General Information (if applicable);

  • Prescription details (if applicable);

  • Service/Treatment/Drug details;

  • Calculation of amount claimed;

  • Additional information (if applicable).

9. Click “Add to Claim”.

Note: You can submit one claim for multiple expenses. After you finish adding the information for one claim and select “Add to Claim”, you can then use the same form to submit another claim.

desjardins insurance patient details webpage

10. Click “Next”.

desjardins dependent page with next button highlighted

You’ll be directed to a confirmation page with the claim details. Your claim has been submitted!

On mobile:

1. Open the Omni app and select “Group Insurance”.

desjardins omni app screen with group insurance button highlighted

2. Enter your User ID and Password.

3. Click "Log on".

desjardins omni app log on screen with user id field, password field and log on button highlighted

4. Click “File a claim”.

desjardins omni app home screen with file a claim button highlighted

5. Read the terms of service for mobile claims service and tap "Accept" or '"Decline".

Note: Desjardins provides useful information on this page on eligible professionals for submitting claims via mobile.

desjardins omni app terms of use screen with accept and decline buttons highlighted

6. Select the name of the patient who received the service or treatment under the “Patient” section.

desjardins omni app file a claim screen with patient field highlighted

7. Select the healthcare provider who provided the service or treatment under the “Professional” section.

Note: If the name of the provider isn’t on the list, click the “+” symbol under the “Professional” section and fill in their information.

desjardins omni app claim screen with professional highlighted

8. Fill out the following information:

  • Service;

  • Date;

  • Amount Paid;

  • Any additional information (if applicable).

9. Click “Continue”.

Desjardins omni app file a claim screen with service fields and continue button highlighted

10. Review your direct deposit and contact information. If everything looks correct, click "Submit".

Desjardins omni app claim screen with submit button highlighted

11. Read the Declaration and Authorization for the Collection and Communication of Personal Information, and select “Agree” or “Cancel”.

Desjardins omni app claim confirmation pop-up with agree button highlighted

You’ll be directed to a confirmation page with the claim details. Your claim has been submitted!

Desjardins omni app claim confirmation screen

 

Claim Status and Claim Forms

To check the status of your claim:

On Web

  1. Click the “Claims history” on your home page.

  2. Select “Processed claims”.

On Mobile

  1. Click the Menu bar in the top left-hand corner.

  2. Select “Mobile history” from the bottom of the list.

Most claims can be submitted online via the process described in this article, but some claims must be submitted to Desjardins with a paper form. 

See a list of claims that are eligible for online or mobile submission (on page 5). If your claim isn’t on the list, you need to complete a paper claim form. Claims also can’t be submitted online if they:

  • Were incurred from professionals not listed in the document above

  • Are paid for compounded prescriptions (made-to-order drugs)

  • Exceed the maximums

  • Require partial payment by a government agency

  • Were incurred outside of Canada

  • Are being claimed for the primary plan member as a coordination of benefits

You can access a list of paper claim forms from your Desjardins online account (on web only) by clicking “Submit a claim” and selecting “Claim forms”.

Contacting Desjardins

Desjardin's contact number is: +1 (800) 263-1810 

You can contact Desjardins from Monday-Friday, 8 a.m. - 5 p.m. 

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