Direct Insurance Billing

Phoenix Physio Clinic is pleased to offer Direct Billing to the majority of Canadian insurance companies in Ontario. Once you provide us with your extended benefits insurance information, we can submit your treatment costs for direct reimbursement, saving you time and reducing your out-of-pocket expenses. We offer this service at no extra charge.

We can direct bill the following insurance companies:

• Sun Life Financial
• Canada life Assurance Company (formerly Great West Life)
• Manulife Financial
• Desjardins Group
• Green Shield Canada Insurance
• ClaimsXchange Insurance
• SSQ Insurance
• Claim Secure Insurance
• IA Financial Group Insurance
• BlueCross Insurance
• BPA Group Insurance
• Canadian Construction Workers Union
• Chambers of Commerce Insurance Plan
• CINUP Group Insurance Pension
• Coughlin & Associates
• Cowan Insurance Group
• D.A.Townley Insurance
• Equitable Life Insurance Company of Canada
• First Canadian Financial Group
• GMS Group HEALTH
• Industrial Alliance Financial Group
• Johnson Insurance
• Johnston Group Insurance
• Beneva Insurance and Financial Services
• LiUNA Local Insurance (Laborers' International Union of North America)
• Manion Health Benefits Administration
• Maximum Benefit
• People Corporation Insurance
• RWAM Insurance Administrators Inc.
• Telus AdjudiCare
• Union Benefits Insurance
• UV Insurance
• Empire Life Insurance

What Is Direct Billing

The insurance companies use the phrase "direct billing" to describe when a service provider bills a client directly. Healthcare providers may charge an insurance company for services they perform directly, such as physiotherapy, massage therapy, chiropractic or naturopathic doctor, by directly charging the insurance company. It relieves the patient of the burden of completing all of the necessary paperwork. In other words, it simplifies the task of submitting insurance claims.

Direct billing for health insurance claims has two key advantages:

• The healthcare provider generally receives payment for services rendered sooner rather than later because they do not need to wait for the policyholder to complete the paperwork. They can simply bill the insurance company directly and receive payment by the invoice due date.
• It also benefits the policyholder in that they would not need to file any paperwork or pay for the costs upfront and wait for the insurance company to reimburse them.

What are Extended Health Benefits?

A benefit known as Extended Health Benefits (EHB), often referred to as Extended Health Care (EHC) or "major medical benefits," is an extra benefit that covers fees and services that the government does not pay.

In many cases, they are provided by your employer, but in certain cases, you may be able to buy them via an Extended Health Benefit Plan Ontario (EHB).

Is Physiotherapy covered by Extended Health Benefits?

Physiotherapy, massage therapy, chiropractic, naturopathic, and other paramedical therapies are included by most Extended Health Benefits policies.But there is a limit to what is covered, and often just a portion of the cost is covered at all times.

For example, a plan could cover 80% of a visit for a total of $500. As a result, you would be responsible for paying 20% of the visit's cost up front (referred to as a co-pay), but your EHB would cover the remaining 80%.

What else is typically covered by Extended Health Benefits?

Most EHB plans cover a portion of medical costs, including physiotherapy, massage therapy, orthotics, chiropractic care, naturopathic medicine, dental, vision, and prescription drug costs.

What your specific plan covers is based on what your company has signed up for and can be found by looking at your benefit plan’s online portal, benefits package booklet, or speaking with a representative in Human Resources or at your Extended Health Benefits plan.

Do I need a doctor’s referral to attend physiotherapy?

The majority of plans do not require a doctor’s referral to attend physiotherapy.

Do I need to pay out of pocket for physiotherapy?

If your plan allows for direct billing (referred to as “assignment of benefits”), then you will not need to pay out of pocket and we can direct bill your insurance company.

The Phoenix Physio Way

We at Phoenix Physio Clinic take great satisfaction in providing physiotherapy that is focused on the needs of each individual patient. Every patient deserves our undivided attention, which is why we exclusively provide private physiotherapy sessions.

When required, our physiotherapists collaborate with our on-site chiropractors and massage therapists.

It allows you to go back to doing what you love! Make sure you mention this article when you CALL (905) 832-1110 so that we may give you 50% off your initial assessment.

Refrences:

• Darrel Pendry, "Direct Billing", accessed January 22, 2021, https://www.insuranceopedia.com/definition/319/direct-billing
• HealthOne, "Direct Insurance Billing", accessed January 18, 2020, https://healthonephysio.ca/direct-insurance-billing