What is Direct Billing?

Direct billing is a service that our clinic offers and allows healthcare providers to bill insurance companies directly on behalf of patients. This means that patients don’t have to pay up front for their treatments and then submit a claim to their insurance provider themselves.

​

When do you bill my provider?

We bill your provider after every visit to our clinic.

​

What if my plan only covers a percentage of the claim?

Don’t worry, you’re still eligible for direct billing. We bill your plan for your treatment and will settle the remainder of your balance in-clinic at the end of each visit.

​

What if I come in for services once I've exhausted my coverage? How do I pay for the services I've received?

If you come in for Chiropractic or Naturopathic services after your coverage is exhausted, we will still bill you at the end of your appointment but you will be responsible for any fees incurred. Please make sure you confirm and understand your extended insurance company coverage details.

​

What happens if my claim gets marked as pending? What does the pending status mean?

If for some unexpected reason your direct billing claim gets denied or is marked as “pending”  we will simply ask that your account balance is paid at the end of your visit. You can then work with your provider to determine why the claim was denied and/or provide additional information as appropriate.

Insurance providers will often mark claims as “pending” for a variety of reasons - it’s nothing to be alarmed about, this just means that they were unable to complete their adjudication process automatically (i.e. they couldn’t auto-approve the claim). This could be for any reason from a systems issue on the insurer's side, to a requirement for additional documentation. In most cases no additional work is required from your side - all you have to do is wait for the claim to be approved.

​

How do I know how much I am covered for?

You will need to contact your extended health carrier, however, due to confidentiality we are unable to obtain access to determine your coverage limits.

​

Can I use my spouse’s benefits as well?

Unfortunately we cannot bill your spouse’s benefits. We only can bill to one extended health carrier each visit, which needs to be your primary insurance company. However, we will provide you with an invoice to submit to your secondary insurance carrier.

​

Do I need a doctor’s referral?

You do not need a doctor's referral to come to our clinic, however, some insurance carrier plans require you to have a doctor's note in order to claim the visit. Please check with your insurance carrier.

​

I am told I have to pay a deductible?

Some plans include deductibles while others do not - check with your insurance provider if this applies.

A deductible is a fee paid at the start of your plan’s fiscal year and is needed in order to activate your plan. The deductible amount is determined by your insurance company. We are still able to direct bill! The way this works in practice is that you will have to pay a higher percentage for your first visit and then your insurance plan will cover more for each subsequent visit.

​

Can I pre-bill for future appointments or past appointments?

We can only direct bill your insurance company on the same day as the appointment. We cannot bill appointments in the future or past appointments.