Insurance claims for qualified applicants*.
Make note if the massage therapy service is performed in British Columbia, then only a BC registered massage therapist is recognized by benefit insurance plans for (e)Claims.
- First appointments should be prepared to make payment day of appointment unless you send insurance details (inc consent) in advance*
* Insurance Qualified? : (read)
- Each Insurer's individual extended health plans vary *
- Each Insurance company has their own consent form that you have to sign in order for electronic submission.
- * It is patient’s responsibility to know about their own coverage prior to booking. (ask your insurance company for details).
What is an electronic billing (eClaim):
- RMT eClaims submissions are a free-service for your convenience.
- You must sign a consent form for eClaims.
- I only provide the information you present to me for your claim.
- I can not communicate about your policy with your Insurance Company
- Nor do I have any influence regarding their decisions on your claim.
Your insurance providers?: (read)
- Pacific Blue Cross;
- Medavie Blue Cross;
- Alberta Blue Cross , Canada Life (inc Great-West Life), Chambers of Commerce Group Insurance Plan, CINUP, Cowan Insurance Group, Desjardins Insurance(?), Industrial Alliance, Johnson Inc., Manulife Financial Maximum Benefit or Johnston Group, and Standard Life Assurance Company of Canada, Public Service Health Care Plan (PSHCP) ... (via Telus eClaims);
- SunLife (Lumino Health).
Patient-pays due insurance restrictions: (read)
e-claims prohibited, insufficient benefit coverage, missing requirements for claim(s) et cetera.
Unsuccessful eClaims must be paid as soon as possible.
- Manulife Financial, Green Shield Canada, Imperial Life, Victor, Olympia, the Co-operators, Group Source, CADA 360 and others have some policies that do not allow e-claims.
- Claims rejection as a resultant requiring a "doctor referral" or "missing insurance information".
- Partial paid e-claims: fees such as deductibles, and insurances coverage (less than 100%) leaving patient balance owing. Then you’ll be notified by email/text/phone to pay the balance. (I do not issue invoices).
- Most Insurance Benefits do not pay for missed appointments. You are responsible for all fees.
- Balances must be paid as soon as possible.
- MSP is a patient claim benefit. (see BC Gov., pay patient claim 1916 form)
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ICBC claims*: may be...
I have "hard opted-out" of ICBC claims. I do not direct bill ICBC.
- ICBC claims: patient-pay, ask your ICBC Adjustor first.
- "Twelve (12) massage therapy sessions provided by a Registered Massage Therapist" are preauthorized for ICBC customers within the first 12 weeks from date of their crash", as per ICBC Fee Guide for Health Care Providers document.
- If further treatments require your Adjusters approval. You will likely need to provide some claims information: date, file#, Adjuster's name and contact in order to complete ICBC form CL751-physical-treatment-plan.
- ICBC may request RMTs to provide clinical records. Your written patient consent is required before hand.
- Please note many private Insurance benefits typically do not cover injuries/accidents for eClaims.
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Work related injuries and WorkSafeBC claims*: Sorry, no!
I have "hard opted-out" of WorkSafe claims. I do not direct bill WorkSafe.
- if injuries occurred during your work and were reported and/or you intend to make a WorkSafeBC claim. NO
- As an opted-out RMT, I can only treat any area except that "listed" by the the claim as the injury.
- Note most insurance benefit policies do not cover work related injuries for eClaims.
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All regulations of BC Health Care Act, (Regulatory) College of Massage Therapy and other Acts apply.
All Insurers agreements must be followed.
A general standardized clinic policy applies: "terms & conditions of service" available at clinic.
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John Forsyth RMT © 2022. All rights reserved.
