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Medavie

Public Health Program Administration

Government partners

Our value: Administrative expertise coupled with modern technology

As one of Canada’s leading all-in-one carriers and public health program administrators, we proudly partner with federal and provincial government departments and agencies to provide comprehensive, cost-effective, flexible solutions. Together with our portfolio of individual and group business, we manage benefits for 1 in 10 Canadians from coast to coast, with an overarching objective to provide timely access to quality care to achieve better health outcomes for a healthier, stronger nation.

Our Expertise

With extensive experience delivering government programs, we excel at creating solutions that enable governments and individuals to thrive. Our offerings ensure the timely and accurate design, implementation, and administration of new programs. Below are some of the government services and solutions we provide:

Benefit plan management

The Medavie Blue Cross Government Programs Division administers health care benefits and services on behalf of our federal and provincial clients. We understand our clients’ unique needs and provide innovative, cost-effective, timely, and sustainable delivery models.

Provider management

Our state-of-the-art electronic claims adjudication system offers the capacity and flexibility to manage diverse program requirements. Our Provider Registry Network includes licensed medical practitioners, facilities, and home care providers, enabling direct and regular reimbursement. It is utilized nationally for our federal and provincial government clients.

Claims processing

We’ve been in the business of electronic claims processing for more than 20 years. Our sophisticated digital platform offers the capability and flexibility to handle a wide variety of program requirements. Our claims processing system and administration expertise provide our clients with comprehensive, easy-to-use solutions.

Provincial Medicare administration

Medavie has over 50 years of experience managing the full spectrum of provincial Medicare, from provider registration, claims management and payment, and all aspects of health card management for residents.

Drug plan administration

Medavie’s extensive experience across various sectors enables us to adopt a comprehensive perspective when devising strategies for our clients. With over 40 years in federal and provincial drug programs, we excel in developing, implementing, and managing drug plans. Our advanced online adjudication system is flexible and capable, accommodating diverse plan designs and client-specific rules.

Prescription monitoring

With over 20 years of expertise, we offer integrated monitoring solutions for controlled substances combined with innovative data analysis and proactive interventions. Our system simplifies data collection and management, enabling effective use, trend identification, and issue response. Our experienced team collaborates with provincial and national stakeholders to drive best practices, research, and new initiatives, reducing the harm from prescription drug abuse and ensuring safer outcomes.

Audit services

Audit Services plays a key role in ensuring the financial integrity of our clients’ programs and financial tracking can take the guesswork out of where program dollars are being spent. Our analysis, monitoring, and audit practices help protect and secure the financial integrity of the health benefit programs we manage for our clients.   

Digital health

At our core, we are a customer-centric, digital-first enterprise dedicated to making quality insurance solutions easily accessible. We collaborate with our government clients to deliver seamless, innovative digital experiences, including online portals, mobile applications, process automation, and other advanced digital assets.