We are pleased to offer direct billing for naturopathic, chiropractic and acupuncture services with the following extended insurance providers:
- Sun Life Financial
- Chambers of Commerce Group Insurance Plan
- Maximum Benefit
- Pacific Blue Cross
How does direct billing work?
You give us your policy number and ID (which is on your insurance pocket card), and we submit through the web portal. We will also require you to fill out some basic paper work, depending on which insurance provider you are with. The portal will give us the exact amount of money that is covered for that visit. If the visit isn't fully covered through your plan, you will be required to pay the remaining portion.
Will I ever have to pay upfront?
- If your plan only covers a portion of the visit (ie. 80%), you will be responsible for paying the difference (ie. 20%) directly to the clinic.
- If your plan does not cover a specific type of service (please check with your extended benefits plan if you are unsure). For example, some plans will cover the costs of a naturopathic appointment and lab tests ordered by your naturopathic doctor, while others will only cover the costs of appointments.
- If there is a deductible that you must pay prior to the insurance kicking in (again please check with you plan if you are unsure).
- If you have reached your spending limit for your plan.
Can you check what my exact coverage is (ie. what services are covered, or the number of visits covered)?
No, the submission portal is designed to create submissions in real time. The system is not designed to check limits/statements/policies, etc. If you want to check your statement, remaining balance, policy details, or deductible, please contact your insurance provider directly.
Why do insurance companies provide different plans for members?
Each plan is individual to the member, and depends on the following factors:
- Your employer.
- Your insurance company.
- The specific insurance plan your employer chooses from the insurance company.
For example, Pacific Blue Cross may cover 10% of the cost of chiropractic visits for some member plans and 100% for other member plans. Another example might be that your spouse has $500 per year for naturopathic services under Manulife, however you might only have $300 per year under Sun Life Financial. The amount of coverage in your plan is decided upon by your employer, and is often negotiated by unions.
What if I have more then one insurance plan? Can you help coordinate them?
Unfortunately, at this time we can only bill one insurance plan per appointment.
Will I receive a receipt if you direct bill for me?
Yes, you will receive a receipt from the insurance web portal that details how much money was directly billed to your plan. You will also receive an itemized receipt from Juniper Family Health.
Can direct billing prepay for future appointments?
No, direct billing can only be used in real time to pay for appointments that have already took place.
What questions should I ask my insurance provider to better understand my plan?
- What is my coverage period?
- What categories of services does my plan cover?
- Do I have an annual deductible?
- What is the maximum amount covered per year for each category? (ie. dollar amount)
- Up to what amount is covered for each visit? Is this amount percentage based or a flat dollar rate? Is this amount different for initial visits versus return visits?
- Are labs and diagnostics covered under naturopathic services, or under another category?
- Do I have coverage for nutritional or herbal supplements recommended by a naturopathic doctor?
- Do I have coverage for prescriptions?
- Do I have a "health spending account" that can be used to cover the expenses that are not covered under my basic health plan?