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Direct billing to insurance (Associate Handbook)

Goal: Provide clear, consistent expectations for clients and protect confidentiality while supporting direct billing.

What we can and can’t say to clients about coverage

If a client asks whether their sessions will be covered by insurance:

What we can say

  • We direct bill to most large insurance providers.
  • We will attempt to charge your insurance.
  • To attempt direct billing, we need your:
    • insurance provider name
    • ID number
    • policy number
    • (or a photo of your insurance card)
  • If you have insurance coverage and we are unable to direct bill, you can still pay the clinic by credit card or e-transfer. We will issue you a receipt and you can submit it to your insurance provider for reimbursement.
  • Even with direct billing, the client still needs a credit card on file to cover any top-up charges or amounts not covered by insurance.
  • The client is responsible for any top-ups, any amounts not covered, or the full fee if coverage is not available.

What we can’t say

  • Please do not say (or imply) that a client’s sessions with Head & Heart Counselling will be covered by their insurance.

What we can and can’t say to an insurer (confidentiality)

If an insurer requests information about therapy:

  • Please share only very minimal, high-level information (e.g., broad session type and a very general topic area) and no clinical detail.
  • Share only what is necessary and authorized.
  • If unsure, please redirect to admin and follow the privacy guidance: Privacy Index

Insurer verification requests (claims confirmation)

From time to time, an insurer (e.g., Manulife, Sun Life, Blue Cross) may contact the clinic to verify that a client’s claimed sessions occurred on the dates submitted.

  • Please route these requests to admin.
  • Confirm only minimal administrative facts as appropriate (e.g., date(s) of service / attendance / provider), and do not share clinical details.

Providers we direct bill to

We direct bill to most large insurance providers. Current list (not exhaustive):

  • AGA Financial Group Inc.
  • Alberta Blue Cross
  • belairdirect (formerly Johnson Inc.)
  • Beneva Inc.
  • Blue Cross
  • BPA (Benefit Plan Administrators)
  • Canada Life (yes, except QC)
  • Canada Life - PSHCP (yes, except QC)
  • Canadian Construction Workers Union
  • Chambers of Commerce Group Insurance
  • CINUP
  • ClaimSecure
  • Coughlin & Associates Ltd.
  • Cowan (yes, except QC)
  • Equitable
  • First Canadian
  • GMS Carrier 49
  • GMS Carrier 50
  • GroupHEALTH
  • GroupSource
  • Industrial Alliance (yes, except QC)
  • Johnston Group Inc.
  • LiUNA Local 183
  • LiUNA Local 506
  • Manion
  • Manulife
  • Maximum Benefit
  • People Corporation
  • Simply Benefits
  • Sun Life
  • TELUS AdjudiCare
  • Union Benefits
  • UV Insurance