Direct billing to insurance
Goal: Provide clear, consistent expectations for clients and protect confidentiality while supporting direct billing.
Intake form + insurance (new workflow)
- New clients will be prompted by the Janeapp to add their insurance information on their intake form.
- Clients who add their insurance information are automatically indicating that they would like us to bill their insurance to cover counselling costs.
- All top-up amounts are billable to the client’s credit card, and clients are responsible for their bill if the insurance declines their claim.
- This means you no longer need to collect nor upload your clients’ insurance information.
- If a client asks you about insurance coverage, please direct them to upload their insurance information to JaneApp, if they havne’t done so already.
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.