Direct Insurance Billing

healthOne is pleased to offer Direct Billing to selected insurance companies.   Once you provide us with your extended benefits insurance information, we can submit your treatment costs for direct reimbursement, saving you time and reducing your out of pocket expenses.

We offer this service at no extra charge. Please be aware that we can’t guarantee direct billing at every appointment due to issues with individual benefits plan, problems with the online submission web-portal or clinic logistic considerations.

We can direct bill the following insurance companies:

  • Great West Life
  • Pacific Blue Cross
  • Green Shield
  • Medavie Blue Cross (RCMP, Canadian Armed Forces, Veterans Affairs)
  • Industrial Alliance
  • Johnson Inc.
  • Johnston Group Inc. (Chamber of Commerce, CINUP, First Canadian and Maximum Benefit)
  • Manulife Financial
  • Sun Life Insurance
  • Cowan (Express Scripts)

 

FAQ

 

How does direct billing work?

We will collect your insurance information (i.e. policy and ID numbers) using our electronic new patient form prior to your first visit or at the time of your visit.  We can then access the insurance payment system online through a web-portal.  The web portal will give us the exact amount that your benefits plan will pay and any amounts remaining that you may need to pay.

 

Will I need to pay anything?

You may need to pay the remainder of the treatment fee, according to the web-portal reply. For example, if you are covered for 80% of your $60 visit fee, you will pay $12. This depends on your individual insurance coverage and web-portal response.

 

What treatments can you direct bill?

While we offer a range of services including manual therapy, active rehabilitation, IMS, shockwave, spinal decompression and more, the treatment type is based on the practitioner providing the treatment (i.e. physiotherapist). Physiotherapy, Hand Therapy (provided by a physio) and Registered Massage Therapy are all eligible treatments for direct billing.  Hand Therapy provided by an Occupational Therapist may NOT be eligible for direct billing or any extended benefits reimbursement.  Each individual plan has different coverage with regards to each treatment type.

 

Can you check my exact coverage or how many visits are covered?

The web-portal is designed for clinics to create submissions in real time.  It works very similar to a credit card terminal – it can collect the payment, but it can’t check the card balance.  With some insurance providers, we can complete a pre-authorization that may provide some limited information.

If you want to check your coverage, remaining balance, deductible or other benefits related policies, please contact your insurance provider directly.

 

Can I use direct billing to prepay for my future visits?

No, we can only direct bill for completed treatments.

 

Can you direct bill for Registered Massage Therapy and Physiotherapy on the same day?

Yes.

 

Do I need a doctor referral?

No. Physiotherapy and Registered Massage Therapy are considered direct-access services in BC. However, we can’t guarantee whether your individual benefits plan has a requirement for a doctor’s referral.

 

Why do some insurance companies provide different coverage for different members?

Each plan is individual to the member. Insurance companies can have many different plans. For example, Great West Life can cover as little as 10% of treatment to 100% coverage.  Your coverage depends on what your employer has negotiated and purchased on your behalf.

 

What if my plan covers 100% of the treatment?

Great – You do not need to pay anything extra for your treatment!

 

What if I have several insurance plans? Can you help to coordinate them?

Currently, only Great West Life insurance supports coordination of benefits. We will supply you with a copy of your primary insurances statement of direct billing submission to submit to your secondary coverage for reimbursement directly to you for any portion you may have paid.

 

Do I get a receipt if you direct bill?

You will get a receipt only for the remaining portion that you pay in the clinic.  We can print the statement of direct billing submission to the web-portal if you would like a copy.

 

What if you cannot process my direct billing, i.e. due to the web-portal being down?

You will pay for your appointment the regular way i.e. cash, debit or credit card. We will provide you with a receipt which will allow you to submit to your plan for reimbursement.