Direct Billing

FAQ

How direct billing works?

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 will pay; you may need to pay the remaining portion of the visit.

Will I need to pay anything?

You may need to pay the remainder of the visit fee, according to the portal reply. For example, if you are covered 80% of your $75 visit fee, you will pay $15 (the portal will “pay” the remaining 60$ to the clinic). It all depends on your individual coverage and portal response.

What treatments you can direct bill for?

Physiotherapy and Massage Therapy treatments. Each individual plan may have different coverage with regards to each treatment type.

Can I check my exact coverage or how many visits or 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 my future visits?

No, we can only direct bill for visits that already took place.

Can you direct bill for Massage Therapy, Chiropracitc and Physiotherapy all on the same day?

Yes.

Do I need a doctor referral?

Generally it is not needed. Physiotherapy, Chiropractic and Massage Therapy are direct access in BC. We can not guarantee however, whether your individual benefits plan has a requirement for a doctor referral. So far, we have encountered only several cases where direct billing was denied due to not having a doctor referral on file.

Why do some insurance companies provide different coverage for different 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 treatment to 100% coverage.

What if my plan covers 100% of the treatment?

Congratulations. You do not need to pay anything extra at your appointment.

What if I have several insurance plans? Can you help to 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 contact the other plan provider on your own.

Do I get a receipt if I direct bill?

You will get a receipt only for the remaining portion that you pay in the clinic; the portion that is not covered by the plan. We can also print the statement of direct billing submission to the portal.

What if you cannot process my direct billing, i.e. due to portal being down?

You will pay for your appointment the regular way i.e. cash, debit or credit card. We will provide you with a receipt which will allow you to submit to your plan.

Are all of Coast practitioners registered for direct billing?

Generally yes. It is possible however, when the practitioner is a locum or new to the clinic that the registration is pending and it may not be available. We always make every effort to ensure that all of our newest members get registered as soon as possible.