Toronto West End Mamas Clinic

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Working Together With Your Insurance Company

Young mother does physical yoga exercise with her baby boy

We do direct billing, wherever possible

We get it.  No one — especially not pregnant mamas or those with little ones around —  has time to deal with insurance companies. It can be complicated to find out what you have coverage for, and to figure out how to be reimbursed for those services.  We feel your pain, mama.

We’re here to make life easier for you.

We work together with many major insurance companies.  Most of them let us do your direct billing for you — this means that they will just pay us, instead of you having to pay at the time of your visit in Toronto, Newmarket & York region.  

What does this mean for you?  Less hassle, since you don’t have to submit the claim, and fewer out-of-pocket expenses, since you only pay what they don’t cover.   

toddler-and-baby-brotherAre all of your services eligible for direct billing?

We are able to do direct billing for these services in both our Toronto, Newmarket & York region locations: chiropractic, physiotherapy (pelvic floor physiotherapy is covered under your insurance plan as “physiotherapy”), massageacupuncture and naturopathy.  We are currently unable to do direct billing for psychotherapy or osteopathy, but if you have insurance coverage for those, you can submit your treatment receipt to your insurer for reimbursement.

How do I know how much insurance coverage I have?

We would be very happy to call your insurance company on your behalf to find out your coverage for you.  If you require this service, we ask that you kindly arrive about 15-20 minutes before your first appointment in order for us to make that call, as they will require you to give us authorization to do so.

Alternatively, you can call them and ask what your coverage is, or look in your employee insurance handbook.  If you can’t decipher your insurance handbook, bring it in and we’ll figure it out together.

 

Less Hassle, More Healing

Which Companies Can You Do Insurance Billing For?

Companies which offer insurance billing in Toronto
  • CINUP
  • Chambers of Commerce Group Insurance
  • Cowan
  • Desjardins
  • First Canadian
  • Great West Life
  • GroupHEALTH
  • GroupSource
  • Industrial Alliance
  • Johnson Inc.
  • Johnston Group
  • Manion
  • Manulife Financial
  • Maximum Benefit
  • Sun Life Financial
My insurance company isn’t listed here.  Does that mean that I won’t be reimbursed for my appointment?

Not at all. It simply means that we won’t be able to do your billing directly for you.  We will still provide you with your receipt at the time of your appointment in Toronto, Newmarket & York Region locations — both in digital and on paper — and you simply have to enter the details into your own insurance company’s claims system for reimbursement.  If you require assistance with your claim process we would be happy to help you with that.

Our practitioners are listed with Blue Cross so that you can be reimbursed by them for your treatments, but we are not able to do the billing directly to Blue Cross.  We are also hoping to be able to do direct billing with Green Shield very soon but it’s not quite available yet.  Stay tuned on that one.

Do you do coordination of benefits?

If you and your partner both have benefits, the regulation is that we have to submit the claim to your insurance company first before you will be able to access your partner’s benefits.  In our experience, direct billing for coordination of benefits is a little hit-and-miss, so we usually suggest that once you have used up your own insurance, that you do the claim on your end for your partner’s insurance.  We will provide you with all of the necessary paperwork to do so.

What happens when I run out of benefits?

All treatments must be paid for at the time of the appointment in both Toronto, Newmarket & York region locations. If you run out of insurance, you may pay by cash, debit or credit card. 

More questions? Get in touch.