Direct Billing

We are now offering direct billing to the following providers:

Alberta Blue Cross (not including Medavie Blue Cross)
ASEBP (Alberta Blue Cross)
Canada Life
Canada Life - PSHCP (Public Service Health Care Plan)
Chambers of Commerce (Johnston Group)
CINUP (Johnston Group)
Equitable
First Canadian (Johnston Group)
GroupHEALTH
GroupSource
Industrial Alliance
Johnston Group
Manion
Manulife
Maximum Benefit (Johnston Group)
RWAM
Coughlin & Associates Ltd.
People Corporation

We do want to mention that we are still in the process of expanding our direct billing. We are actively learning these new systems and the rules and requirements of each individual provider. And so, we appreciate you understanding that although we might not always have the answers, we are excited to learn with you as we go.

Lastly, we are still looking into additional providers so the above list will continue to be updated. If you would like us to let you know if/when we start to bill to your provider, please let reception know and we can add you to a list for any updates. We do appreciate your understanding if yours isn’t one that we ultimately expand to include. *

*Each insurer is unique. Not all providers offer real time approvals, and each provider has their own payment frequency/method. Although we would love to offer every client the convince of direct billing, not every provider works with our current business needs.

Direct Billing

Prior to your appointment

As insurance policies vary greatly, the best way you can prepare is to contact your insurance provider ahead of time to find out the following:

Do you have coverage for Massage Therapy?
Can a service provider/clinic direct bill on your behalf?
What date do your benefits re-set?
What do your benefits cover per treatment/ per year?
Does my plan require I pay a deductible?
Do you need a Drs note?

If so, it is important to be aware that it will need to be sent directly to your insurance provider, before your treatment. They may also require it to be mailed in or take time to process it so make sure to plan accordingly. It is also important to know if a new massage prescription is required every 12 months.

Important things to know

Please note that all fees are ultimately the responsibility of the patient. If your insurance providers’ direct billing portal system is down and not responding or the claim does not go through for any reason (shows as declined or pending/ for review), you will be required to pay the full amount of your visit up front.

We are unable to direct bill to your secondary insurance company. Many times, the primary and secondary insurance companies do not coordinate and can delay the reimbursement process. We ask that you pay your remaining balance up front and submit your receipt to your secondary insurance company yourself.

*exception- If you have primary coverage with Alberta Blue Cross and secondary coverage through Alberta Blue Cross it should automatically submit any remaining to your secondary plan.

Only completed treatments are eligible to be claimed or directly billed. We are unable to direct bill for future treatments, missed treatments, or treatments paid for by gift card.

What to bring to your appointment

Your Insurance card with policy number and member ID
A valid piece of government-issued photo ID
An additional method of payment (in the event that there is an issue with the system, or a claim doesn’t process in real time for any reason).

If you are not the primary cardholder for the plan, we are also required to have the primary cardholder’s full name and date of birth to process your claim

When you arrive

Intake Form- In order to bill your insurance provider directly we do require an authorization and consent form to be completed.

It is important that we have this completed before your appointment, so our front desk staff have permission to begin the process and are ready to submit your claim when the session is complete.

To avoid cutting into your treatment time, we recommend you arrive 10-15 min prior to your appointment to complete this. If you prefer to do this ahead of time, please contact us at info@3leaf.ca and ask to have a form emailed out to you.

Direct Billing FAQ

Who do we direct bill to?

Alberta Blue Cross & ASEBP (not including Medavie Blue Cross)
Canada Life
Canada Life - PSHCP (Public Service Health Care Plan)
Chambers of Commerce (Johnston Group)
CINUP (Johnston Group)
Equitable
First Canadian (Johnston Group)
GroupHEALTH
GroupSource
Industrial Alliance
Johnston Group
Manion
Manulife
Maximum Benefit (Johnston Group)
RWAM
Coughlin & Associates Ltd.
People Corporation

Insurance providers subject to change

Can I use my spouse’s benefits as well?

We are able to bill to only one extended health provider per visit. If you have additional coverage available, you may submit the provided receipt to your secondary insurance provider. It is also important to note that we are required to bill your primary insurance plan.

*exception- If you have primary coverage with Alberta Blue Cross and secondary coverage through your spouse through Alberta Blue Cross it should automatically submit any remaining to your secondary plan.

What if my visit is only partially covered?

If your visit is partially covered, we will bill the approved amount through your insurance provider and take payment from you directly for the remaining balance.

Do I need a doctor’s referral?

At 3 Leaf we don’t require a Drs referral. However, it is important to check in advance with your insurance provider/ plan to see if they require one.
It is also important to find out:

Are you required to get a new referral annually?
Once submitted to your insurance, how long does it take to process (so you can schedule your appointment accordingly).

**Please make sure to submit your Drs referral directly to your insurance provider.

What is a deductible?

Some insurance providers require a deductible. A deductible is the amount you pay out of pocket before your insurance starts covering costs.
For inquiries regarding your deductible, please contact your insurance provider.

What if my claim cannot be processed at the time of my visit?

If your claim is denied for direct billing, we require the full amount to be paid at the end of your visit. Once paid, you will be able to submit your receipt directly to your insurance for reimbursement.

If the claim comes back as pending, we may be able to take payment for the service from you and still submit it on your behalf (with the reimbursement going back to you if/when it becomes approved). If this is an option, we will offer it to you.

Why isn’t my direct billing working?

It is important to note that every plan and insurance provider is different. Also, we are not able to access your plan on your behalf, to find out what you need or what you have available. For this reason, it is always best to contact your insurance provider directly with any questions.

However, these are some common reasons your direct billing might not be working:

A Dr’s referral is required
Your online account hasn’t been activated
Your insurance providers online portal is being updated or undergoing maintenance
Computer or Internet issues that impact our ability to access the portal
Your plan requires paper submissions
Your coverage limit has been reached

Other important things to note:

Only completed treatments can be claimed through direct billing or for reimbursement. This means we are unable to bill for missed appointments, future appointments or appointments paid by gift card.
It will only be at the time of your treatment that we will be able to confirm if direct billing will work with your plan.
We cannot directly bill for 2 hour massage sessions to some insurance providers due to restrictions in their system. This includes, Alberta Blue Cross.

If you have any questions please contact our team and we would be happy to help.