The process of a Physiotherapy Clinic billing an insurance company directly for rehabilitation services.

Direct Billing And Insurance Coverage

Learn everything you need to know about insurance coverage and direct billing.

Direct Billing Physiotherapy

What Is Direct Billing?

Direct billing simplifies payment for healthcare providers’ services. With this method, providers charge the insurance company directly for the services provided to insured clients. As a result, clients don’t have to pay upfront and seek reimbursement later.

Once the rehabilitation service is provided, the our physiotherapy clinic submits a claim to the insurance company detailing the service. The insurer then reviews the claim for validity and compliance with the client’s policy benefits. The provider is paid directly for the covered services if the claim is approved.

On the client’s side, they present their insurance details to the provider before or during service. The client may only be responsible for any uncovered charges, such as co-pays or deductibles, at the time of service. This direct billing arrangement simplifies the payment process, making it more convenient and efficient for both the provider and the client.

Direct Billing to ICBC & More

If you have been involved in a car accident and suffered an injury, consider pursuing multiple treatments covered by ICBC to support your recovery process. Starting April 1st, 2019, ICBC will cover and pay for the specified treatments for new and existing claims.

You can access our team of healthcare professionals, who will create personalized treatment plans to help you recover successfully. They will provide you with dedicated one-on-one care throughout your healing journey.

If you have sustained injuries in a motor vehicle accident and possess a claim number, ICBC medical benefits will encompass ICBC physiotherapy, chiropractic, kinesiology, registered massage therapy, acupuncture treatments, and additional services.

Verifying Your Insurance Coverage For Extended Health Care

Verifying insurance coverage before scheduling an appointment with our active rehab clinic is important to ensure a smooth and hassle-free direct billing process.

By following these steps, you can ensure that your direct billing insurance coverage is accurately verified, allowing you to benefit from our direct billing services without any inconvenience.

Direct Billing And Insurance Coverage

Here’s how you can confirm your direct billing and insurance coverage with us:

Contact Your Insurance Provider:

Contact your insurance provider listed under our accepted providers and inquire about your eligibility for the specific service you need at our facility. Make sure to provide your policy number.

Required Information:

When contacting us to schedule your physiotherapy or Surrey massage therapy service, please be ready to provide the following information:

  • Your full name as it appears on the insurance policy
  • Policy number and member I.D.
  • Date of birth
  • Insurance company’s name
  • Any relevant additional coverage details (if applicable)

Confirmation of Coverage For Direct Billing Insurance :

We suggest you complete the direct billing verification process well before your appointment. After you have confirmed your eligibility and the extent of your coverage with your insurance provider, please inform us of the confirmation. Our Revive Rehab team may also perform a pre-verification check to ensure everything is in order before your scheduled rehabilitation service.

We recommend doing this direct billing verification process well before your appointment. Once you have confirmed your eligibility and extent of coverage with your insurance provider, inform us about the confirmation. Our Revive Rehab Abbotsford team may also perform a pre-verification check to ensure everything is in order before your scheduled service.

Direct Billing Insurance Companies

Accepted Insurance Providers For Direct Billing At Revive Rehab

We can direct bill the following insurance companies:
  • Benecaid
  • Beneva by La Capitale
  • BPA
  • Canadian Construction Workers Union (CCWU)
  • Canada Life (formerly Great West Life)
  • Chambers of Commerce Group Insurance Plan
  • Claim Secure Insurance
  • Coughlin
  • Cowan (Express Scripts)
  • D.A. Townley
  • Desjardins Insurance
  • Empire Life
  • Equitable Life of Canada
  • First Canadian
  • GMS
  • Green Shield Canada
  • Group Health
  • Group Source
  • Honeybee
  • Humania Assurance
  • ICBC
  • Industrial Alliance
  • Johnson Inc.
  • Johnston Group Inc.
  • Labourers International Union (Locals 183, 506)
  • Manion
  • Manulife Financial
  • Maximum Benefit
  • Medavie Blue Cross (RCMP, Canadian Armed Forces, Veterans Affairs & Interim Federal Health Program (IFHP))
  • MEDIC Construction
  • Pacific Blue Cross
  • People Corporation
  • RWAM
  • SSQ Insurance
  • Sun Life Insurance
  • Union Benefits
  • UV Insurance
  • WorkSafe BC

Obtaining Pre-authorization for Certain Rehabilitation Services

Insurance providers may require pre-authorization for certain services or treatments to ensure direct billing and insurance coverage.

Follow these steps to obtain pre-authorization:

1.Consult Your Primary Care Physician: If you require a service that needs a referral, the first step is to talk to your primary care physician. Explain your condition and the recommended service. Your physician can then provide you with a referral or the necessary medical documentation to justify the need for the service.

2. Submit the Documentation to Your Insurance Provider: Contact your insurance provider with the referral or medical justification in hand. Fill out a pre-authorization form and submit it along with the documentation provided by your primary care physician.

3. Wait for Approval: After submitting the required documentation, there will be a waiting period while your insurance provider reviews your request. The duration of this process may vary, so it is crucial to begin it as soon as possible.

4. Keep Us Informed: Once you receive authorization from your insurance provider, please let us know immediately and provide us with a copy of the authorization. This will allow us to schedule your service based on your direct billing and insurance coverage.

Following these steps can obtain pre-authorization, ensure your rehabilitation treatment is covered, and reduce unexpected expenses.

Co-Payments and Deductibles Of Direct Insurance Billing

After pre-authorization, co-payments, deductibles, or other out-of-pocket expenses may still apply based on your insurance policy. Clients are responsible for any co-payments and deductibles as stipulated in their insurance agreements.

  • Co-payments are fixed amounts required by your insurance plan for various services. They must be paid at the time of service and can vary depending on the type of service rendered.
  • Deductibles are the amount you must pay out-of-pocket each year before your insurance starts paying its share. The deductible amount varies across different policies and must be met before the insurer covers any claims.

To find out the amount of co-payment or deductible you are responsible for, please refer to your insurance policy documents or contact your insurance provider directly. We collect co-payments during our Abbotsford physiotherapy treatments and can help estimate your deductible based on information given by your insurance company. However, we recommend that you interact directly with your insurer for the most accurate assessment.

Claims Process For Direct Billing

Claims Process For Direct Billing

Submitting insurance claims is a crucial step in managing your healthcare expenses. Submitting all required documentation promptly is imperative to ensure a smooth direct billing and claims process. Typically, this involves completing a claim form provided by your insurance company, attaching all relevant itemized receipts, and providing any additional documentation that supports your claim, such as prescriptions or a letter from your healthcare provider detailing your treatment.

The processing time for insurance claims can vary, usually ranging from a few weeks to a couple of months, depending on the case’s complexity and the insurance provider’s efficiency. During this period, your insurance company may reach out for further information or clarification if needed. It is advisable to keep copies of all documents submitted for your records.

To facilitate a timely and favorable resolution of your direct billing claim, ensure that all forms are filled out accurately and completely and verify that you have included all necessary documentation before submission. If you have any questions about the direct billing claims process or require assistance with your claim forms, our administrative staff can help guide you.

Privacy and Confidentiality for Direct Billing

At our physiotherapy clinic Surrey, we understand the importance of safeguarding your personal and insurance information. That’s why we prioritize your privacy and security during the direct billing process. We take all necessary steps to ensure that the data shared with us, including your insurance details, is handled with the utmost care and by strict privacy regulations. This guarantees that your information is secure and processed in a manner that respects your privacy rights.

Our team is well-versed in privacy policies and practices. They are trained to handle your insurance information with the utmost confidentiality and use it solely for direct billing purposes. You can trust our commitment to safeguard your information throughout the direct billing process.

Responsibilities of Clients When Direct Billing

Direct Billing And Insurance Coverage For Treatments

Clients have a crucial role in the direct billing and insurance coverage process and must fulfill various responsibilities to ensure that their claims are processed efficiently and accurately. Firstly, clients must ensure that their insurance information is accurate and up-to-date. This entails providing their healthcare provider with the correct insurance policy numbers and informing them of any changes in insurance coverage.

Secondly, clients are responsible for providing their healthcare provider with accurate and complete personal information, details of the nature of their visit, and any relevant medical history that may affect the treatment or insurance claim.

Lastly, clients must comply with the requirements set by their insurance company. This involves understanding their policy’s coverage, co-payments, and deductible amounts and adhering to any procedures or documentation requirements specified by their insurer for the direct billing claims process.

By fulfilling these responsibilities, clients can significantly contribute to ensuring a hassle-free direct billing and insurance coverage process and timely processing and payment of their claims.

Billing Policies At Revive Rehab

Our physiotherapy clinic is dedicated to providing transparent direct billing policies to ensure our clients are fully informed about their financial responsibilities. After the appointment, we generate invoices for the services rendered and, if possible, directly bill the client’s insurance provider. However, we will send an invoice via email or postal mail for services not covered by insurance based on the client’s preference.

Clients are required to pay for services not covered by insurance of receiving the invoice. We accept payments via credit/debit cards, bank transfers, or cheques. We advise our clients to review their invoices carefully and contact our billing department immediately if they notice any discrepancies or concerns.

We will notify you if the payment is received after the specified timeframe. If the non-payment continues, we may have to suspend services until the outstanding balance is cleared. We understand that financial situations can be challenging, and we encourage our clients to contact us promptly if they face any financial difficulties so that we can discuss possible payment arrangements.

For billing inquiries or disputes, clients can contact our billing department at:

Phone: 604.503.5552 or 604.746.1116

Our team is here to assist you with any questions or concerns related to your billing statement. We are committed to ensuring that your direct billing and payment process is as smooth and understandable as possible.

DIRECT BILLING AND INSURANCEFrequently Asked Questions About Direct Billing And Insurance Coverage

Are there any limitations for direct billing?

Direct billing has some limitations:

Partial Coverage –If your plan does not include the full visit cost, you will receive a bill and a receipt for the uncovered amount at the visit’s conclusion.

Secondary Coverage—We cannot arrange secondary coverage for any insurance you may hold through your spouse unless you are insured with Pacific Blue Cross. The insurance providers set this restriction.

Future Payments—We can only invoice your insurance plan after services have been provided; we cannot bill for upcoming appointments.

Split Invoices – We cannot divide invoices to align with your plan’s maximum limits.

Direct billing to my insurance provider: when does it occur?

We invoice your provider following each visit to our physiotherapy clinic Abbotsford and Surrey.

What happens if my plan only partially covers the claim?

Rest assured that you are eligible for direct billing. Your treatment costs will be charged to your plan, and any remaining balance can be paid at the clinic after each visit.

If my claim is marked as pending, what are the implications? What does the pending status signify?

If your direct billing claim is denied unexpectedly or marked as “pending,” we will ask you to pay your account balance at the end of your visit. You can work with your provider to understand why the claim was denied and provide any necessary information.

Insurance providers may label claims as “pending” for various reasons, typically due to issues in their adjudication process. This doesn’t indicate a problem; it simply means that the claim couldn’t be auto-approved. Reasons for this can range from system glitches to documentation needs. Usually, no extra effort is required; you need to wait for claim approval.

How can I determine the extent of my coverage?

Please reach out to your extended health provider for assistance. Unfortunately, we cannot access your coverage limits for confidentiality reasons.

May I also use my spouse's benefits?

Regrettably, we are unable to bill your spouse’s benefits. Per our policy, we can only bill one extended health provider per visit, and this should be your primary insurance company. Nevertheless, we will furnish you with an invoice you can submit to your secondary insurance provider.

Is a doctor's referral required?

You do not require a doctor’s referral to visit our rehab clinic. However, specific insurance plans may necessitate a doctor’s note for visit reimbursement. Kindly verify this requirement with your insurance provider.

Do I need to pay a deductible?

Please note that some insurance plans have deductibles, while others do not. It’s advisable to confirm this information with your insurance provider to be sure.

A deductible is an upfront fee that initiates your plan’s fiscal year and is required to activate your coverage. Your insurance company sets the specific deductible amount. Please be aware that we are still able to handle direct billing.

In practice, this means that for your first visit, you will be responsible for a higher percentage of the cost, while your insurance plan will cover subsequent visits to a greater extent.

Can I invoice in advance for upcoming or previous appointments?

We can only bill your insurance company on the day of your appointment. Please note that we cannot process direct billing for future or past appointments.