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Direct Billing

Get Your Health Services Without Paying Upfront

Direct Billing Program

What is Direct Billing for Extended Health Insurance?
 
If your company offers an employee benefits plan, chances are you will have extended health insurance that will cover a number of health services not covered by MSP.
 
What Services are Covered by my Extended Health Insurance Plan?
 

Common services that extended health insurance plans might include are:

  • Massage Therapy
  • Naturopathic Medicine
  • Acupuncture
  • Chiropractic
  • Counselling and Psychotherapy
Typically you will receive a certain dollar amount (i.e. $300 – 500) toward a particular service to be used within the year. 

Providers who Direct Bill include

  • Pacific Blue Cross

  • Great West Life

  • Sun Life Financial

  • Manulife

  • Greenshield
  • Medavie

  • Chambers of Commerce
  • Group Insurance

  • Johnston Group

Do other Providers Offer Direct Billing?

Yes!

Autism Society, First Nations Authority are some examples of non-non-government organizations which offer funding for services like Counselling. You will need to apply direct and get a letter confirming the amount covered. These are typically billed directly by Cave as well.

ICBC – have an injury? We direct bill to ICBC for you.

 

 

What Services Can be Direct Billed for?
 

The three main services that can be direct billed by Cave, so you don’t pay up-front, are:

  • Registered Massage Therapy

  • Acupuncture

  • Chiropractor
  • Counsellors

Do all Extended Health Plans offer Direct Billing?

Each plan is unique to the individual, and depends on the following factors:
1. Your Employer
2. The Insurance Company
3. The specific Plan or Policy that your Employer chooses within this

For example, your Pacific Blue Cross policy might include $500 toward massage therapy, while your spouse’s Great West Life policy through their employer might only get $300.  Amounts are decided on by each company, and are often negotiated by unions.  Also, you may get 100% coverage of your service, whilst your spouse may only get 85% coverage, etc.

How is Direct Billing done?

Simply bring your extend benefits card which includes your policy and plan numbers and we can directly bill for you!  

Will I Ever Have to Pay up Front?

Each plan is different so it depends on your plan.
If your plan only covers a portion of the visit (i.e. 80%) you will have to pay the difference to the clinic,
If your plan has a deductible, which you pay on your first visit, you will have to pay the difference to the clinic.
No all services can be billed directly, however you can still claim for your service, you will need to keep your receipt and submit it yourself via mail, email, or an app.

Questions to ask your provider:

Being prepared for direct billing before you come in for your first visit for is always a good idea.  Due 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:

What is my coverage period?
What Health Services am I covered for?
Do I have an annual deductible?
What are my maximums for each category?  (dollar amount)
Up to what amount is covered per each visit?  Is it different for initial visits versus follow-ups?
Does my plan cover Counsellors or only Psychologist?

Direct Billing FAQs

You can learn the details of your coverage by contacting your extended health carrier or from your plan administrator.

How do I know how much I am covered for?

You can learn the details of your coverage by contacting your extended health carrier or from your plan administrator.

What if my visit is partially covered by my extended health carrier?

We can still bill your carrier! If your visit is partially covered we will bill the covered amount to the carrier and ask that you pay the balance of your visit at the end of each treatment.

Can I claim for more than one service at a time?

Yes, if you book multiple services in one visit, we can book directly for you.

Do I need a doctor’s referral?

Cave Cure & Therapies does not require a doctor’s referral however some plans do require one. Please check with your extended health carrier to learn your plan requirements.

What if I have an open ICBC, Worksafe or other insurance claim?

If you have an open insurance claim we direct bill your visit directly to ICBC. You will need a referral.

What if my claim is denied?

If your visit is denied for online direct billing we ask that your balance is paid in full at the end of each treatment. The front desk staff will advise you if your claim has been denied before you leave. Please note: Some plans have restrictions that do not allow for online direct billing but you can still claim via email, app, or online.
To check if you are eligible for this service please contact your extended health carrier.

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