Insurance Coverage and Direct Billing
What is direct billing?
Instead of having to manually submit insurance claims, we can either direct bill your company or submit the claim on your behalf as a courtesy service. We know insurance paperwork is tiresome and can get in the way of using your insurance company benefits. Direct billing allows us to bill your insurance company directly right after your visit so you don't have to mess with forms, claims, and phone calls.
Are your services covered by my plan?
Most extended benefits plans cover Registered Massage Therapy(RMT) visits and Acupuncture services.
We don’t have access to your insurance plan, so it’s best if you check with your employer or insurance provider to learn what your benefits cover. Even though we’d like to help, we’re not allowed to access your account to see what is left, or inquire about the details of your coverage (that information is private to you).
Some extended health plans may offer 100% coverage and unlimited visits. Other health plans may work similar to a bank account, where you can “spend” up to a certain dollar amount as you see fit. Only your specific plan provider can give you the details about your coverage.
Some benefits plans will only reimburse the expense if it has been referred by a physician, please check with your provider if this is the case before coming to the clinic.
Which Companies Can You Direct Bill With?
Are there any limitations?
There are a few limitations to direct billing:
Partial Coverage – If your plan doesn’t cover the cost of a full visit, you will be billed and issued a receipt for what was not covered at the end of the visit.
Secondary Coverage – We are not able to coordinate any secondary coverage that you may have through your spouse. Unfortunately this is a limitation from the insurance providers themselves.
Future Payments – We can only bill your insurance plan when services are rendered – we cannot bill for future appointments.
Split Invoices – We are not able to split invoices in order to coordinate with your plan’s maximums.
What we need from you for direct billing
Before you come for your appointment, please fill out the Direct Billing Authorization Form accurately. It is included in your health history and intake form. Without your insurance information or authorization for direct billing, we are unable to provide direct billing for you. In case you have not received the form, you can contact our clinic to send it to you.
We are happy to be able to offer direct billing with over 20 extended health benefit insurance providers!
Some of the common plans we see are:
- Canada Life (Great West Life)
- Manulife
- Sun Life
- ClaimSecure
- Desjardins
- Equitable Life of Canada
- Industrial Alliance (iA Financial Group)
- People Corporation
- Green Shield Canada
- SSQ Insurance
- Empire Life
Exceptions
Unfortunately there are always exceptions to every rule. In some cases we will ask you to pay in full at the end of your visit and submit your receipts to your insurance company for reimbursement.
This might happen if:
- Your insurance company’s online portal is down
- Your insurance company responds to our direct billing request with a ‘pending’ status (meaning that they are unable to complete the adjudication process)
- We submit your claim on your behalf and your insurance company provides you the payment instead.
- Your insurance plan requires you to submit your claims manually instead of direct billing.
- You’ve booked with a new registered massage therapist or acupuncturist who isn’t set up with your provider yet.
- Your benefit provider is not on our list of insurance companies for direct billing.