Direct Billing to Health Insurance Companies

Direct Billing Physiotherapy

Opal Physiotherapy offers Direct invoicing to most insurance companies; We can bill most of the Insurers for physiotherapy benefits plan from our front office directly to help you save time in submitting your receipts to your insurance provider. The biggest advantage of direct invoicing is that it will reduce any out-of-pocket expenses or upfront fees related to your treatment. In addition, due to Covid-19, if you opt for telehealth, we can also bill most of the service providers for the online sessions.

We can submit invoices directly to the following health insurance companies:

and the following health insurance companies too:

Canadian Construction Workers Union, Chamber of Commerce Group Insurance, CINUP, Cowan, D.A. Townley, Desjardins, Insurance, First Canadian, GMS Carrier 49, GMS Carrier 50, GroupHEALTH, GroupSource, Industrial Alliance, Johnson Inc., Johnston Group Inc., La Capitale Insurance and Financial Services, LiUNA Local 183, LiUNA Local 506, Manion, Maximum Benefit, People Corporation, RWAM Insurance Administrators, Sun Life Financial, TELUS AdjudiCare, Union Benefits, UV Insurance, Equitable Life Ins of Canada, SSQ, Empire Life, Coughlin.

There are no charges applicable for Direct billing your physiotherapy services provided at Opal Physiotherapy; we will need your Insurer’s Plan or policy Number and Member ID Number to process this, but please do let us know in advance that it is an insurance claim to help you process the insurance claim efficiently.

Note: we can not guarantee direct invoicing at every appointment unless informed prior to the session due to certain complications with certain Insurers’ benefits plan policies or due to problems with the submission portal.

Please be advised that we will require a credit card on file for the direct charge for certain companies due to unpredictable insurer portal connectivity.

Direct Billing – Frequently Asked Questions

Does Opal Physio do direct billing?

Yes, Here at Opal Physiotherapy, we do direct billing to most of the health insurance providers, ICBC and WSBC.

How does direct billing work for extended health benefits?

You would be required to provide us with your policy number or claim ID number, and we will submit it using the providers’ web portal. Upon submission, the health insurance provider portal will let us know the amount your benefits plan covers, and the balance payment may be required to be paid by the client.

What treatments can you direct bill?

Health insurance providers cover most of the physiotherapy treatments that are provided at Opal Physio. Still, it is always advisable to call your Insurer or us to know your eligibility before the appointment date.

What if you have an open ICBC, WorkSafe or another insurance claim?

 When you have an open ICBC or Work Injury, It is best to claim treatment expenses through the relevant Insurer. Then, all you need is the Claim Number that you will be given when you report the motor vehicle accident injury to the ICBC phone line or a work injury to your Manager through an incident report and WSBC by phone.

Do I need a doctor’s referral?

Although you do not need a Dr’s note to see a physiotherapist, it is always good to see your doctor and have a referral if your insurance policy requires you to have one. It is best to check your Insurer before your scheduled appointment.

Can you check what my exact coverage is or how many visits are covered?

We may be able to check your eligibility for that visit and how much you would be required to pay if applicable, but unfortunately, we would not be able to check the complete coverage limit and the number of visits covered unless you are physically at the clinic and authorize us to call the insurers (provided if we are able to access the insurers’ phone line quickly.)

What happens if my extended health carrier partially covers my visit?

If your extended health benefit partially covers your visit, then you would need to pay the balance amount of the total cost of the visit.

What happens if your claim gets denied?

If the health insurance company denies your claim, then you would be required to pay the charges incurred for the visit.

What if I have several insurance plans?

 ICBC and WSBC insurances cannot be combined with any other insurances.  Suppose your spouse also has benefits that will cover you. In that case, some insurers will allow us to direct bill both the primary Insurer for the main portion of the coverage and the remaining portion with the secondary Insurer. Still, most of the insurers will cover only the primary coverage, where you will be required to pay the remaining portion that the Primary Insurer did not cover. You will be receiving a receipt for the portion you paid, so you will be able to submit manually or electronically (if your insurance provider has a direct portal).

What happens if the portal is down and we are unable to complete the direct billing process?

Occasionally when there are glitches due to portal issues, where we are unable to direct bill the Insurer, you will be required to pay the amount incurred and claim it yourself.