INSURANCE | PRIMARY HEALTH INC.

DIRECT BILLING

We are proud to announce that Primary Health direct bills to over 12 insurance companies. All you have to do is bring your insurance providers’ information card; it will look something like this:

Most extended plans cover massage therapy and many offer direct billing. It’s best to check with your insurance provider before your appointment to see how much is covered and whether you require a doctor’s note in advance for reimbursement purposes.

If your insurance company is not set up for direct billing with Primary Health, please be prepared with an alternate form of payment. You may arrange for subsequent reimbursement with your insurance company.

Reduce your out-of-pocket expenses.

Eliminate insurance paperwork.

Will I need to pay anything?

You may need to pay the remainder of the treatment fee, according to the web-portal reply. For example, if you are covered for 80% of your $60 visit fee, you will pay $12. This depends on your individual insurance coverage and web-portal response.
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, Great West Life can cover as little as 10% of treatment to 100% coverage. Your coverage depends on what your employer has negotiated and purchased on your behalf.
Do I need a doctor referral?

While some insurance companys consider certian services direct-access meaning no referral is required others may need to have a referral or doctors script to meet eligibility requirements. Due to the variations in policies, we can’t guarantee whether your individual benefits plan has a requirement for a doctor’s referral and you should consult with your insurer before booking services.
Can you check my exact coverage or how many visits are covered?

The web-portal is designed for clinics to create submissions in real time. It works very similar to a credit card terminal – it can collect the payment, but it can’t check the card balance. With some insurance providers, we can complete a pre-authorization that may provide some limited information. If you want to check your coverage, remaining balance, deductible or other benefits related policies, please contact your insurance provider directly.
How does direct billing work?

We will collect your insurance information (i.e. policy and ID numbers) using our electronic new patient form prior to your first visit or at the time of your visit. We can then access the insurance payment system online through a web-portal. The web portal will give us the exact amount that your benefits plan will pay and any amounts remaining that you may need to pay.
What treatments can you direct bill?

While we offer a range of services including manual therapy, active rehabilitation, IMS, shockwave, spinal decompression and more, the treatment type is based on the practitioner providing the treatment (i.e. physiotherapist). Physiotherapy, Hand Therapy (provided by a physio) and Registered Massage Therapy are all eligible treatments for direct billing. Hand Therapy provided by an Occupational Therapist may NOT be eligible for direct billing or any extended benefits reimbursement. Each individual plan has different coverage with regards to each treatment type.
What if you cannot process my direct billing, i.e. due to the web-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 for reimbursement.