FAQs of Direct Billing for your Extended Health Insurance

Extended Health insurance plans often include alternative and complementary medical services, such as Acupuncture,Massage therapy that you would otherwise have to pay for out of pocket.

Common services that extended health insurance plans might include are:
  • Acupuncture
  • Massage Therapy
  • Naturopathic Medicine
  • Physiotherapy
  • Chiropractic
  • Custom Foot Orthotics
  • Counselling and Psychotherapy
  • Dental
  • Eye care and glasses
  • Fitness Spending
  • Discretionary funds to use how you like!  You need to ask about this!
Typically you will receive a certain dollar amount (i.e. $300 – 500) toward a particular service.  

How is Direct Billing done and what's the benefits?

Before direct billing came available, it used to be that the only option for getting these services paid for was to pay for them yourself upfront, submit the receipt either by mail or online, and then wait for a cheque in the mail (or a direct bank deposit).  The turnaround time to get the money this way can be prohibitive for people who are tight on cash.  
Most of the insurance companies provide the eClaims portal to clinics like ours or the healthcare providers to submit the eCalims for our clients and get paid directly, reducing your out of pocket payment and saving you the hassle of both submitting and waiting for your money!  
The insurance companies or providers that Oriental Acupuncture Clinic can direct billing to: 
  • Blue Cross
  • Chambers of Commerce 

  • Cowan
  • Desjardins
  • First Canadian Benefits
  • Great West Life
  • Green Shield
  • Industrial Alliance
  • Johnson Inc
  • Johnston Group
  • Manulife Financial
  • Maximum Benefit
  • RBC insurance
  • SSQ Financial Group
  • Standard Life
  • Sun Life
  • Veterans Affairs Canada
  • Canadian Armed forces
  • Veterans Affairs
  • RCMP: Royal Canadian Mounted Police

This is great news!  All you have to do is bring your policy and plan numbers (you should have a wallet card) on your first visit and sign up the consent forms, so we can start the eClaims for you. 

Will I ever have to pay up front?

3 cases that you have to pay upfront:
  1. If your plan only covers a portion of the visit (i.e. 80%) you will have to pay the difference to the clinic,
  2. If your company does not do Direct Billing at all or for specific types of services (so call your insurance company to find out if you not sure)
  3. If it’s the first time using Direct Billing Services the Insurance Company sometimes blocks the first transaction because they want to make sure a real person can verify that it’s legitimate.  This does mean that you will have to pay up front on your first visit, but it usually clears up for follow-ups. 

Common Questions to ask your Insurance Company:

Being prepared for direct billing before you come in for your first visit for is always a good idea.  Do to privacy issues, you are the only one who can ask about your plan!  Plan to make a quick phone call and ask the following questions:

  1. What is my coverage period?
  2. What Categories am I covered for? Acupuncture or Massage therapy etc.
  3. Do I have an annual deductible?
  4. What are my maximums for each category?  (dollar amount)
  5. Up to what amount is covered per each visit?  Is it different for initial visits versus follow-ups?
  6. Do I need a referral from an MD to obtain any of these services?
  7. Do I have separate “health spending account” or “fitness account” that can be used for other health care services not listed above?

Call Oriental Acupuncture Clinic  at 416-800-3978 
or Text:416-655-1311
to set up your first appointment!
Healing from the root, beyond treating symptoms.
So you can experience greater health and well-being!

With Jarry's 28 years clinical experienceyou will feel the difference.

1 comment:

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