Reaching out to as many people as possible is our passion. Therefore, we are pleased to offer a Direct Billing Program to those with Pacific Blue Cross, Green Shield and all the companies that are managed through Telus E-claims for Massage Therapy and Acupuncture. Telus E-claims includes Great-West Life, Manulife, Sun Life, Cowan, Johnson Group, Chamber of Commerce, First Canadian, Industrial Alliance, Desjardin, Cinup and Maximum benefit. We offer this service free of charge, in order to make your experience more enjoyable.
We also continue to direct bill Medavie Blue Cross for our Veterans, and our RCMP members. Thank you for your service to our country and community.
In order to serve you best and ensure that we have all information needed to submit to your insurance and track it on your behalf, we ask that you give us your insurance policy information by filling out our Direct Billing checklist. You will find this check list either on your initial intake form that is sent out to you at the time of booking, or we can send a separate one as needed if you are a current client, or have changed insurance companies. If you are new to the clinic, we require a day prior to your appointment to create your profile. This will make the process seamless and will minimize waiting at the desk during set up.
How does the Direct Billing program work?
Once we have your profile updated with your insurance information, we will be able to Direct Bill to your insurance company. Keep in mind, every insurance plan is different so there may or may not be a co-payment or a deductible. The Payment portal will give us the exact amount that the insurance company will pay and you are responsible for whatever amounts are not paid by the insurance company at the time of treatment. If, for some reason, the insurance portal is down, we will bill you the full amount and ask that you submit to the company when their payment portal is back on line.
Please be aware that we cannot guarantee direct billing at every appointment. This could be due to issues with individual insurance plans, problems with the submission portal, or clinic administration considerations.
Facts about Direct Billing:
How does Direct Billing work?
You give us your policy number/ID and we submit it through the web portal. The portal will give us the exact amount that your benefits plan pay; you will need to pay the remaining portion of the visit that isn’t covered, if anything.
Will I need to pay anything?
You will pay the portion of the treatment cost that the insurance company doesn’t pay, according to the portal reply. For example, if you have coverage for 80% of your $75 visit fee, you will pay $15 (the portal will “pay” the remaining $60 to the clinic). Payment amounts depend on your individual coverage and portal response. There may also be a deductible that you have to pay before coverage begins. Check with your insurance company.
What treatment modalities can you bill for?
We can bill for both Massage Therapy and Acupuncture treatments. Each individual plan may have different coverage for each treatment type, check with your insurance company.
Can you check what my exact coverage is or how many visits are covered?
The submission portal is designed for clinics to create submissions in real time; it is not designed to check statements/limits/policies etc. It works very similar to a credit card terminal – it can collect the payment but it can not check the card balance.
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 future appointments?
No, we can only direct bill for a treatment that already took place.
Why do Insurance companies provide different coverage for their members?
Each plan is individual to the member. Insurance companies can have many different plans. For example, we have seen Pacific Blue Cross cover as little as 10% of the treatment cost up to 100% coverage.
What if my plan covers 100%?
Yay! You won’t have to pay anything!
What if I have several insurance plans? Can you help coordinate them?
Unfortunately, at this time, we do not offer any coordination of benefits. We can only direct bill one plan. You will have to submit your receipt for the balance of the treatment cost to the other plan provider on your own.
Do I get a receipt if you direct bill for me?
You will get a receipt only for the portion that you pay. For example, if you have 100% coverage, you will not get a receipt. If you have 80% coverage, you will get a receipt for the 20% remaining balance that you pay.
Are all of Equilibrium Therapists registered for Direct Billing?
Generally yes. It is possible however, when the Therapist is a locum or new to the clinic that the registration is pending and it may not be available yet. We always make every effort to ensure that all of our newest members get registered ASAP. If your Therapist is not yet registered at the time of treatment, we will ask that you pay for your treatment cost up front and submit to your company personally. We will assist in any way possible.