View
5
Download
0
Category
Preview:
Citation preview
1 888 711 1119 ATTN: SERVICE PROVIDERS SUBMITTING ONLINE CLAIMS
• • • PREFIX MUST BE ENTERED WITH STUDENT NUMBER
DEPENDENTS (OLDEST TO YOUNGEST)
01
02
03
04
Use of this card authorizes the provider to submit personal information to Green Shield Canada necessary for claims adjudication. This card is not transferable. Unauthorized use of this card constitutes
fraud. Coverage eligibility is subject to benefits outlined in the contract and premiums paid. student.greenshield.ca
24-HOUR TRAVELEMERGENCY MEDICAL
1.800.936.6226Toll-free (Canada & USA)
0.519.742.3556Collect (other countries)You must call WITHIN 48 HOURSof commencement of treatment.
GSC TRAVEL # 5492
Recommended