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WHAT YOU NEED TO KNOW

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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:

  1. Alberta Blue Cross
    1-800-394-1965 www.ab.bluecross.ca
     

  2. Canada Life
    1-800-957-9777 www.canadalife.com
     

  3. Chambers of Commerce
    1-800-665-3365
    www.my-benefits.ca
     

  4. Claim Secure
    1-888-513-4464 www.claimsecure.com
     

  5. Desjardins
    1-800-463-7843
    www.desjardins.com/ca/alberta
     

  6. Equitable Life
    1-800-265-4556
    www.equitable.ca
     

  7. Green Shield Canada
    1-888-711-1119
    www.greenshield.ca
     

  8. Group Health
    1-833-344-6944
    www.grouphealth.ca
     

  9. Group Source
    1-888-547-6947
    www.groupsource.ca
     

  10. Industrial Alliance
    1-877-422-6487
    ia.ca/individuals
     

  11. Johnston Group
    1-800-893-7587
    johnstongroup.ca/my-benefits
     

  12. Manulife
    1-866-407-7878
    www.manulife.ca
     

  13. Maximum Benefit
    1-800-893-7587
    www.maximumbenefit.ca
     

  14. Medavie Blue Cross
    1-888-873-9200
    www.medaviebc.ca
     

  15. People Corporation
    1-800-875-7982
    www.peoplecorporation.com
     

  16. Sunlife Financial
    1-800-361-6212
    www.sunnet.sunlife.com

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

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.

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