Direct Billing

We do offer direct billing with the following providers:

Canada Life (Great-West Life), Manulife Financial, Sun Life Financial, BPA, Canadian Construction Workers Union (C.C.W.U.), Chambers of Commerce Group Insurance Plan, CINUP, ClaimSecure, Cowan Insurance Group (managed by Express Scripts Canada), Desjardins Insurance, First Canadian, GMS Carriers 49 and 50 (Express Scripts Canada), GroupHEALTH, GroupSource, Industrial Alliance, Johnson Inc., Johnston Group, LiUna Local 183, LiUna Local 506, Manion, Maximum Benefit, TELUS AdjudiCare, Green Shield Canada (GSC), Empire Life, and Blue Cross/Blue Shield.

I am passionate not only about providing exceptional care, but also about making it accessible. That is why we have recently started offering direct billing to your insurance company.

Many private insurers/group benefit plans offer full or partial coverage. If you have extended health benefits, we may be able to submit your claim electronically from our office. Please check your plan carefully for details or limitations.

If eClaims direct submission is not available for your plan or service rendered, we will gladly provide you with a paper or digital statement for paid service and you can submit manually.

Please check the list below to ensure that your insurer is a participating member of Telus Health eClaims.

To get started with your submission we will need you to fill in the following form. Please download the form, fill it out and submit to victoriaswansonrmt@gmail.com prior to your appointment.

FAQ

How does direct billing work?

You give us your policy number and ID (which is on your insurance pocket card), and we submit through the web portal (Telus Health eClaims). We will also require you to fill out some basic paperwork (listed above). The portal will give us the exact amount of money that is covered for that visit. If the visit isn’t fully covered through your plan, you will be required to pay the remaining portion.

Will I ever have to pay upfront?

Occasionally.

If your plan only covers a portion of the visit (ie. 80%), you will be responsible for paying the difference (ie. 20%) directly to the clinic.
If your plan does not cover a specific type of service. See below for what to ask your insurance company.
If there is a deductible that you must pay prior to the insurance kicking in. See below for what to ask your insurance company.
If you have reached your spending limit for your plan.
In the situation that your insurance company reimburses you instead of the clinic, or if the submission states that the beneficiary is unclear. In the later case you will be required to pay for the service and will be refunded if we receive the deposit.

Can you check what my exact coverage is (ie. what services are covered, or the number of visits covered)?

No, the submission portal is designed to create submissions in real time. The system is not designed to check limits/statements/policies, etc. If you want to check your statement, remaining balance, policy details, or deductible, please contact your insurance provider directly.

What if I have more than one insurance plan? Can you help coordinate them?

Unfortunately, at this time we can only bill one insurance plan per appointment.

What questions should I ask my insurance provider to better understand my plan?

All massage therapy services we provide have the potential to be covered by insurance. However, there are other factors and potential insurance plan limitations which will determine if we are able to charge your Insurance Company directly.

We recommend that you call your insurance company first and ask the following questions:

Does your plan allow a Registered Massage Therapist to charge directly to the insurance company and are massage therapy services covered under your plan?
Will the funds go to the service provider or the insured member?
Does your insurance company require a doctor's note to get reimbursed for your massage treatment?
When is the start and finish of your benefits plan?
How much does the member get per year, per family member?
Is there a percentage or set amount that is paid per treatment?
At the time of your appointment, we will attempt to bill your primary insurance plan. Fortunately, we are able to find out right away if your treatment is covered and how much your plan reimburses you. Even though your Insurance Company allows direct billing there is a chance your treatment could get audited. If this situation occurs, you will be responsible to pay for your treatment and a receipt will be issued to you for payment.