WHAT YOU NEED TO KNOW
Navigating the intricacies of insurance billing can be daunting. Our Direct Billing page is your key guide in understanding all you need to know about billing to your insurance provider, your responsibilities, and the role of our clinic in this process. It's all about equipping you with knowledge to ensure a seamless experience.
This page provides crucial insights into various topics like co-pay, coordination of benefits, your coverage, and much more. You will also find a list of insurance providers we directly bill to for your convenience. Our goal is to ensure you're well-informed, so you can focus on what truly matters – your health and wellness.
INSURANCE PROVIDERS WE DIRECTLY BILL TO
Here is a list of insurance providers we directly bill to, including their contact numbers and websites:
Alberta Blue Cross
Chambers of Commerce
Green Shield Canada
Medavie Blue Cross
Understanding Direct Billing
At our clinic, we offer direct billing services for most extended health insurance providers, meaning we bill your insurance company directly for the services provided. This system streamlines your experience and removes the need for you to navigate the paperwork independently.
Know Your Coverage
It's essential to familiarize yourself with your insurance plan. Knowing what treatments are covered and the limits of these coverages is your responsibility. For example, if your plan covers 80% of charges up to $100, and the charge is $120, the insurance will pay only $80, not $96. Understanding your plan will help avoid unexpected out-of-pocket expenses.
Direct Billing Eligibility
Some insurance plans may not allow direct billing. It's crucial to confirm with your insurance provider if your plan supports this. If direct billing isn't permitted, you will need to pay upfront, and we will provide a receipt for you to claim the expenses from your insurance provider.
Coordination of Benefits and Primary Provider
Coordination of Benefits (COB) is an important concept to understand. It prevents the overpayment of claims when you are covered by more than one insurance plan. We can often only bill directly to your primary insurance provider, and you would need to claim the balance from your secondary provider.
Co-payments, or co-pays, are your share of the treatment cost. If your insurance plan includes co-pays, you are required to pay this amount directly to us at the time of service.
We Don't Have Access to Your Plan Details
Please note that we do not have access to your individual insurance plan details. This includes information about your coverage limits, co-pay amounts, or remaining balance for the year. We encourage you to maintain an active understanding of your insurance plan details.
Assignment of Benefits
When you opt for direct billing, you are required to sign an Assignment of Benefits form. This document authorizes us to bill the insurance company directly and to receive payments on your behalf. It simplifies your payment process, but it doesn't negate your responsibility to track your coverages.
Handling Rejected Claims
At times, insurance providers might reject a claim for various reasons. In such cases, we will inform you about the rejection, and you will be required to pay for the service rendered. It will then be your responsibility to liaise with your insurance provider regarding the claim.
Your Role in Direct Billing
Direct billing is a partnership between you, us, and your insurance provider. While we handle the billing process, we count on you to understand your coverage, pay any co-pays or uncovered fees, and manage any issues with the insurance company directly.
For any specific questions regarding your coverage, please contact your insurance provider directly. It's a good practice to understand your insurance plan's specifics to ensure a seamless and comfortable experience at our clinic. We appreciate your understanding and cooperation in these matters.