Direct Billing to Extended Health

  • Direct Billing to Extended Health

    Posted by Crystal on June 7, 2022 at 7:37 pm

    Hello fellow RCCs,

    I am interested in offering direct billing to insurance companies (e.g. Pacific Blue Cross, Manulife, etc.) for counselling sessions if clients have extended health benefits that cover counselling. Does anyone have any experience setting this up, as well as familiarity with which insurance companies typically cover sessions with RCCs? I’m also curious about becoming a provider for ICBC if such a thing exists. I’m looking for ways to minimize up front costs for clients, and make it as convenient as possible for them to access therapy. If yes, please let me know, feel free to respond here or send me an email at crystal@aspiretherapeutics.ca

    Thanks!

    Eva Pedersen replied 10 months, 1 week ago 5 Members · 12 Replies
  • 12 Replies
  • Rana

    Member
    July 28, 2022 at 11:53 am

    Hi Crystal – not sure if you’ve already gotten the answer but there’s a page on this on the BCACC resources website:

    https://learn.bcacc.ca/groups/general-discussion/forum/discussion/direct-billing-to-extended-health/

    I have personally signed up with Lumino (Sunlife) & PBC Providernet as a vendor so I show up in the list of counsellors through their extended health apps, but I don’t offer my clients direct billing – except for clients with FNHA (which was why i set it up in the first place). Please email me at connect@ranahakami.ca if you want to talk more about my system.

    Best wishes getting everything set up!

    Rana

    • Crystal

      Member
      August 17, 2022 at 9:50 am

      Thank you so much for your helpful reply Rana. For some reason the link you provided just keeps circling me back to this discussion forum thread and I would really like to read the BCACC resource page on insurance and direct billing, are you able to help me figure out where it is located?

  • Tricia Toth

    Member
    February 25, 2023 at 4:16 pm

    If you are interested in becoming a vendor with ICBC, you can find information here:

    ICBC-vendor-number-application-requirements.pdf

    Tricia Toth

    • Crystal

      Member
      February 26, 2023 at 3:50 pm

      Thank you so much Tricia!!

  • Eva Pedersen

    Member
    April 12, 2023 at 7:14 pm

    If anyone is interested in taking this topic on as a bit of a research project, let me know. I would like to know more about different extended health providers – different rates, direct or client billing, and becoming an approved provider.

    • This reply was modified 1 year, 3 months ago by  Eva Pedersen.
    • Crystal

      Member
      April 30, 2023 at 9:48 pm

      So far I have successfully registered to direct bill with Medavie Blue Cross and am in the process of signing up with Green Shield and ICBC. Pacific Blue Cross has said they do not offer the direct billing option to RCCs at this time. I have not yet had a client with Medavie coverage book in, but I look forward to when I do and can test-drive direct billing for them!

      • Eva Pedersen

        Member
        May 3, 2023 at 3:27 pm

        Thanks Crystal for those updates. Much appreciated!

      • Anna Vaisser

        Member
        July 6, 2023 at 7:37 pm

        Hi Crystal!

        I am wondering how your process with ICBC went. It seems they require a Business City License to sign up as a vendor. It didn’t seem to be part of the process just a few weeks ago. Do you have any insight into this? Thank you! Anna

        • Crystal

          Member
          September 10, 2023 at 5:20 pm

          Hi Anna, thanks for being patient with me as I’ve been busy going through the process. ICBC does require a city issued business license now for their application which I did have and was able to use, although I don’t know when they made this a requirement. I did read in the ICBC portal that if your city supports you working under someone else’s business license (e.g. if you work out of a multidisciplinary office, or in a group practice) then you are able to obtain a letter from the city you’re practicing in stating they allow that instead of acquiring your own business license. Does that help at all?

    • Crystal

      Member
      September 10, 2023 at 5:32 pm

      Hi Eva,

      So far I have been able to register with Green Shield, Medavie Blue Cross, and ICBC for direct billing, although I’ve not yet had any clients with those insurers. As far as I can tell, Green Shield and Medavie have a variety of different coverages for their different group policies. For example, if Green Shield was their insurance provider, a client working at Walmart would be part of a group Walmart Employee policy through Green Shield. That unique policy would cover a certain percent (e.g. 70%) up to a dollar maximum (e.g. $125) per counselling session for all the people on the plan. This may be different from another Green Shield group plan for, say, London Drugs employees that offers 80% to a maximum of $100 per counselling session. Both plans are offered through the same insurer, but the policies are different depending on what each employer purchases for their employees.

      In this example, you can still charge a client your regular session rate, then the insurance provider would cover their allowable amount as outlined in the policy, and if there was a difference, say your rate is $150/hr, then the client would pay the remaining balance. Does that make sense?

      In essence, there is no one-size-fits-all amount of coverage or amount a counsellor can bill for private insurers like Medavie and Green Shield. I gather there is for ICBC though. I believe they have standard pre-set amounts they will cover per session for all customers accessing services. In this case you would still be able to charge the client any difference between the amount ICBC pays and what your session fee is if your fee is higher.

      • This reply was modified 10 months, 1 week ago by  Crystal. Reason: replied to incorrect thread
    • Crystal

      Member
      September 10, 2023 at 5:38 pm

      Eva I accidentally replied to your comment lower down in the thread to myself 😅

      If you were interested in registering with Green Shield to direct bill, you can go here: http://www.providerconnect.ca/ (it’s a fairly easy process)

      If you were interested in registering with Medavie Blue Cross to direct bill, you can go here:

      https://www.medaviebc.ca/en/health-professionals/register

  • Eva Pedersen

    Member
    September 10, 2023 at 6:16 pm

    Crystal thanks so much for your time! That’s super helpful. Eva

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