Accepting new patients and insurance qualified*, Registered Massage Therapist in Penticton.
Direct Billing, for your convenience, to most major insurance companies, some conditions apply*. (ICBC patient pay, WorkSafe NO)
== page index =====================
This page contains information on Insurance providers and ICBC. Please read.
Booking portals on the first four pages of website.
== Important information: recommended
This website contains most of the information you need to know about 'clinic operations'
If you take the time to read it, it will add to your experience.
== Patient's responsibility: ============
Do your know your policy's coverage?
Perhaps ask your insurance company before booking?
If covered for massage. How much coverage? Then ask them, how much does my policy pay for. For example 60 mins. at $115.50.
Note:
At RMT's discretion (" ? ") .
Call or text me is you need assistance?
Note: insurance only pays for appointments you attend!
== Patient's responsibility: continued ===
* Patient's (aka Member) responsibility to know your insurance coverage : (policy)
== Clinic's conditions on Direct-billing ===
* The clinic's conditions for "Direct Billing" that qualify: (policy - conditions)
Otherwise, the service is a patient pay, assigned a receipt for patient self-claim.
* Note - Policies requiring a doctor's note are only patient/member pay
== Direct-billing as a Service =========
This clinic's policy on Direct Billing (eClaim) service on behalf of the patient:
THIS CLINIC'S DIRECT-BILLING PORTALS
Direct Billing these insurance providers (by Portals - Insurance): (read)
note: " ? " = new insurance company, unknown coverage, as well patient's new to clinic = Patient-pay first.
== THE PATIENT-PAYS AT THIS CLINIC =
Patient-pays due to insurance policy restrictions: (read)
== ICBC - PATIENT-PAYS AT THIS CLINIC
ICBC claims*: Yes, only as a patient-pay service *. (read)
I have "hard opted-out" of ICBC claims. I do not direct bill ICBC *.
================================
Massage Therapy is a health profession that operates under the Min. of Health as a private business.
All regulations of BC Health Care Act, (Regulatory) College (of Massage Therapy) and other Acts apply.
All Insurers agreements must be followed.
== page index =====================
This page contains information on Insurance providers and ICBC. Please read.
Booking portals on the first four pages of website.
== Important information: recommended
This website contains most of the information you need to know about 'clinic operations'
If you take the time to read it, it will add to your experience.
- Terms of Service & First Appointment page; and,
- Appointments, Fees & Policy; Contact & Location, and
- Insurance pages.
- email booking confirmation notice (read)
== Patient's responsibility: ============
Do your know your policy's coverage?
Perhaps ask your insurance company before booking?
If covered for massage. How much coverage? Then ask them, how much does my policy pay for. For example 60 mins. at $115.50.
Note:
- First appointments should be prepared to make payment day of appointment unless you send insurance details (inc consent) in advance*
At RMT's discretion (" ? ") .
Call or text me is you need assistance?
Note: insurance only pays for appointments you attend!
== Patient's responsibility: continued ===
* Patient's (aka Member) responsibility to know your insurance coverage : (policy)
- It is patient’s responsibility to know about their own coverage prior to booking.
- Does your policy pay the Provider? (do not know or if not, then patient-pay only)
- Does your claim require a doctor referral? (do not know or if not, then patient-pay only)
- You will have to sign a 'consent form' for Direct Billing (eClaims/electronic submission).
- You are expected to pay services rendered, if any of the following: member (patient) pay, insufficient coverage, doctor note and or if claim is not immediately processed at time of submission or for any other reason.
- It's your responsibility to update your insurance information with the clinic.
== Clinic's conditions on Direct-billing ===
* The clinic's conditions for "Direct Billing" that qualify: (policy - conditions)
- Only insurance policies that have massage therapy coverage.
- Only insurance that have a portal for RMTs to submit claim.
- Only claims that are immediately processed as "Provider pay", the RMT is the provider.
Otherwise, the service is a patient pay, assigned a receipt for patient self-claim.
* Note - Policies requiring a doctor's note are only patient/member pay
== Direct-billing as a Service =========
This clinic's policy on Direct Billing (eClaim) service on behalf of the patient:
- RMT eClaims submissions are a free-service for your convenience.
- You must sign a consent form for Direct-Billing (eClaims).
- I only provide the information you present to me for your claim.
- You must declare cardholder, primary and secondary insurances, and provide (card/DOB) information.
- I can not communicate about your policy with your Insurance Company
- Nor do I have any influence regarding their decisions on your claim.
- Only claims that are immediately processed qualify for Direct-Billing as "Provider" pay (only).
- Clinic policy reminder: by booking your have accepted all Terms & Conditions of Service!
- Some of the Direct-Billing portals are not accepting "doctor's notes" from the Provider (RMT). As result, the Member/Patient pay and must submit to their Insurance provider.
THIS CLINIC'S DIRECT-BILLING PORTALS
Direct Billing these insurance providers (by Portals - Insurance): (read)
- Pacific Blue Cross portal - Pacific Blue Cross;
- Medavie Blue Cross portal - Medavie Blue Cross ;
- Telus Health portal - Alberta Blue Cross , Beneva (?), BPA (?), Canada Life (inc Great-West Life), Canada Life - PSHCP, Canadian Construction Workers Union (?), Chambers of Commerce Group Insurance Plan, CINUP, ClaimSecure (?), Coughlin (?), Cowan Insurance Group, DA Townley (?), Desjardins Insurance (?), Equitable Life (?, First Canadian (?), GMS (?), GroupHEALTH (?), GroupSource (?), Industrial Alliance, Johnson Inc., Johnston Group, LiUNA local 182 (?), LiUNA local 506 (?), Manulife Financial (?), Maximum Benefit (?), NDN Insurance (?), Peoples Corp (?), RWAN (?), Simply Benefits (?), Telus AdjudiCare (?), Union Benefits (?) and UV Insurance (?) ;
- Lumino Health portal - SunLife.
- Green Shields & Others: do not have portals for RMTs.
note: " ? " = new insurance company, unknown coverage, as well patient's new to clinic = Patient-pay first.
== THE PATIENT-PAYS AT THIS CLINIC =
Patient-pays due to insurance policy restrictions: (read)
- Policy does not have coverage for massage in the province of British Columbia.
- Claims that are not immediately processed,
- "member" pay polices (are "patient-pay")
- Policies that do not allow Direct Billing (or have a portal for RMTs claims such as another Province or Country).
- Direct Billing submissions requiring a "doctor's notes", are Patient/Member claim only.
- injuries sustained outside of Canada or by a third party are patient pay.
- Any unsuccessful Direct Billing claims, the balances must be paid as per clinic policy. Then you’ll be notified by email/text/phone to pay the balance (via etransfer). All balances should be reconciled in 24-hours.
- Insurance only pays for appointments you attend!
== ICBC - PATIENT-PAYS AT THIS CLINIC
ICBC claims*: Yes, only as a patient-pay service *. (read)
I have "hard opted-out" of ICBC claims. I do not direct bill ICBC *.
- ICBC claims: patient-pay, ask your ICBC Adjustor about any details first (rates etc.). Or Click on buttons below for information.
- "Twelve (12) massage therapy sessions provided by a Registered Massage Therapist" are pre-authorized for ICBC customers within the first 12 weeks from date of their crash", (quote as per ICBC Fee Guide for Health Care Providers document), as per 2024 ICBC the initial 12 weeks (details click buttons below),
- Added specific bookings for initial & subsequent appointments as per 2024 ICBC practitioner fees. (details click button below)
- You should provide some claims information: date, file#, Adjuster's name and contact in order for treatment.
- If further treatments beyond the intitial "12". Then you require your Adjusters approval. You may need a doctor's prescription and a request the RMT to completed ICBC form CL751-physical-treatment-plan on your behalf.
- Your clinical record is protected by BC PIPA.
- Please note many private Insurance benefits typically do not cover injuries/accidents at work.
================================
Massage Therapy is a health profession that operates under the Min. of Health as a private business.
All regulations of BC Health Care Act, (Regulatory) College (of Massage Therapy) and other Acts apply.
All Insurers agreements must be followed.
== NOT AVAILABLE AT THIS CLINIC ===
Work related injuries and WorkSafeBC claims*: NO (read)
I have "opted-out" of any work related injury.
- I do not treat work-related injuries nor do I direct bill WorkSafe.
* I can only treat area(s) (not indicated as the work injury) as a patient-pay!
- Note insurance benefit policies do not cover work related injuries.
MSP coverage: I do not charge or bill the MSP fee.
I have (Hard) opted-out RMT, so this is a patient self-claim.
10 visits per calendar year at $23.00 plus GST per visit.
Contact MSP 1 800 663 7100 for information.
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John Forsyth RMT © from 2022. All rights reserved.