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Direct Billing
Direct Billing With Less Out-of-Pocket Payment
With direct billing, you may be eligible to pay no upfront fee after treatment. You can leave all the paperwork hassles to the clinic. Our experienced administrative staff will walk you through the whole process of direct billing; from registering online account to getting reimbursement from insurance company.
Insurance with Direct Billing Accepted:
Primary insurance companies
| Insurer |
|---|
| Sun Life |
| Canada Life |
| Manulife |
| Blue Cross |
| Green Shield Canada |
| Desjardins Insurance |
| Beneva (formerly SSQ) |
| Empire Life |
| iA Financial Group |
Third-party administrators (TPA)
| Administrator | Note |
|---|---|
| ClaimSecure | Listed once only |
| Johnston Group | Administrator of the Chambers Plan |
| People Corporation | |
| Coughlin & Associates Ltd. | |
| Cowan Insurance Group | |
| D.A. Townley | |
| GMS Carriers 49 and 50 | Group Medical Services |
| LiUNA Local 183 | |
| LiUNA Local 506 | |
| Manion | |
| Maximum Benefit | |
| MDM Insurance Services Inc. | |
| RWAM Insurance Administrators Inc. | |
| Simply Benefits | |
| TELUS AdjudiCare | |
| Union Benefits | |
| UV Insurance (Union Vie) |
Government and workplace channels
| Channel | What it covers |
|---|---|
| WSIB (Workplace Safety and Insurance Board) | Workplace injuries: Musculoskeletal (MSK) Program of Care, Mild Traumatic Brain Injury (mTBI) Program of Care, Physiotherapy Fee for Service, Work Hardening Program |
| MVA / auto insurance (HCAI) | Injuries from a motor vehicle accident, submitted through HCAI |
| IFHP (Interim Federal Health Program) | Physiotherapy assessment and treatment for eligible IFHP clients |
How to check whether you can be billed directly
Follow these steps before your appointment to see if your plan supports direct billing:
- Find your insurer name on your benefits card.
- Note your policy number and member ID.
- Confirm your plan covers physiotherapy or the specific service you need.
- Call us with your card details before your visit.
- We verify your eligibility through our portal.
- You pay only the difference if any remains after the insurer response.
When direct billing is not available
Sometimes direct billing is not available for certain plans. This can happen if your insurer is not on our list, if you have an out-of-province plan, if your plan requires a doctor pre-authorization before submission, or if you use a self-managed health spending account.
In these cases, you use the pay-and-submit route. You pay for your visit at the end of your appointment, and we provide you with a detailed itemized receipt. You then submit this receipt directly to your insurer for reimbursement.
Direct Billing Q&A
Do you offer direct billing on medical items? Like Braces, Orthotics, Compression Stockings and TENS unit?
Yes, we offer direct billing service on all eligible medical items, include Braces, Orthotics, Compression Stockings and TENS unit, as long as your insurance policy allows direct billing.
Does direct billing fully eliminate all out-of-pocket payment?
It depends, if your insurance policy has 100% coverage for the services and you may not need to pay upfront at all.
However, you will still be responsible for any portion of the fee that your insurance plan does not cover. Based on:
- Co-Payment (or Co-Pay)
- Deductible
- Maximum Limit Coverage
- Non-Covered Service/Rate Difference
Direct billing eliminates the need for you to submit paperwork and wait for reimbursement, and it greatly reduces your upfront cost, but it is ultimately depend on your policy.
Do you offer direct billing for claims covered under WSIB?
Yes, If you are covered by WSIB, the benefits pay for a number of costs related to workplace injury and illness, including: Health care; Prescription drugs; Medical devices and orthotics; Transportation costs associated with work-related injury or illness. In most cases, WSIB will pay the health care provider directly. Your case manager, together with your nurse consultant, will advise you on how to claim for these benefits and how each benefit is paid.
After reporting your workplace injury to your employer and WSIB, you should seek for medical attention as soon as possible. Again, at Pro Fusion Rehab, we will send your rehabilitation bill to WSIB directly and you can recover and go back to work faster.
Are you able to direct bill through auto insurance providers?
Yes, according to Financial Services Commission of Ontario, the mandatory auto insurance you purchased contains statutory accident benefits, which provides you with benefits if you are injured in an automobile accident, regardless of who caused the accident, including supplementary medical, rehabilitation and attendant care, caregiver, non-earner and income replacement benefits. Options exist to increase most of these coverages.
If you were unfortunately injured in car accident, we will help you to go through the necessary paperwork from insurance company, and with your written consent we will bill auto insurance directly and you can focus on getting better.
Do you accept OHIP coverage or Ontario Works
We do not accept OHIP and Ontario Works coverage at this moment. However, if you don’t have any other benefit we do offer affordable rates for the community. Please contact us to find out if you are eligible.
Do I need doctor’s note or referral?
General speaking the doctor’s note is not mandatory. However if you are claiming through your Employee Group Benefit/Extended Health Coverage, a doctor’s note may be required when submitting your claim, and it will also help our therapists to diagnose and serve you better according to the medical information on your doctor’s note.
Our Treatments and Services Covered by Insurance
- Physiotherapy
- Massage Therapy
- Acupuncture
- Mobilisation and manual therapy techniques
- Interferential electro therapy
- Shockwave therapy
- Ultrasound therapy
- Kinesio Taping techniques
- Manual Lymphatic Drainage and Decongestive Therapy
- Bracing/Support
- Custom Made Orthotics
- Compression Stockings
- TENS Unit
Helping Patients in Milton and Pickering With Quality Care
Find The Physiotherapy Clinic Near You
Pro Fusion Rehab has 2 well designed and modern rehabilitation clinics, located at Pickering and Milton Ontario.
Pickering Physiotherapy Clinic
Milton Physiotherapy Clinic
Try Our Direct Billing Service
Lower Your Upfront Payment
We direct bill most of the Group Health Benefits, WSIB and Auto Insurance Company