MEDICAL INSURANCE DIRECT BILLING
SERVICE AND POLICY

Increasing access to health care services is our passion. Therefore, we are pleased to offer a Direct Billing Program at Cornerstone Clinic. Direct billing medical insurance plans is a courtesy we offer our clients, and is not a mandatory program.  We offer this service free of charge, in order to make your experience more enjoyable.

 

We will try to directly bill only to those companies that may allow for it and for those policies that will pay the health care provider directly.

 

PLEASE NOTE:  Everyone’s medical insurance policy is different.  In some cases, your insurance provider may not allow the clinic to be paid directly or assignment of benefits.  In this case, you will be asked to pay for your session in full. We will issue you a receipt for you to submit your claim to your insurance provider. You will then receive reimbursement directly from your insurance company.

 

How does the Direct Billing Program work?

 

1. Submit your insurance policy number/ID to our office via online forum, or direct billing forms completed in office.

2. We will look into your insurance coverage, and let you know the details of your coverage. Please note that everyone’s insurance plan is different and you may require to obtain a doctor’s note for coverage, or have a deductible that you need to pay.

 

·         We will check into your coverage for chiropractic and massage therapy services for you.  However clients are responsible to ensure their benefit plan does cover services by either profession & whether or not a doctor’s note is required.

·         If you require a doctor’s note, and don’t have one at the time of your appointment, we will have to take full payment for your session. You can submit your claim once you have obtained a doctors note, and once on file we will be able to submit all future appointments on your behalf.

·         If you are covered by your own insurance as well as a spouse/partner’s plan, the insurance rules are that you must claim against your own plan 1st until it’s used up and then you can claim on the alternate plan. Please be advised that some plans / insurers do not allow coordination of benefits through direct billing.

IMPORTANT: In order for us to be able to direct bill for you we require a Visa or MasterCard number to be held on file.

If we encounter a problem with your billing, we never charge your card automatically.  Sometimes the insurance company pays the client instead of our client, loses a claim or denies a claim.

We first call you and the insurance company to rectify the situation and only charge the card as a last resort, but not before speaking with you – the cardholder. Thanks for your understanding!

 

Facts about Direct Billing:

 

Will I need to pay anything?

Some insurance plans do not cover the full amount of our service fees. If this is the case, you will pay the portion of the appointment that the insurance company doesn’t pay. For example, if you have coverage for 80% of your $40 visit fee, you will pay $8. Your insurance company will pay the remaining $32 to the clinic. Payment amounts depend on your individual coverage. There may also be a deductible that you have to pay before coverage begins.

Can I use direct billing to prepay for future appointments? 

No, we can only direct bill for appointments that already took place. Each company differs in how retroactively we may direct bill as well, spanning from 2 months to 1 year, inquire for more details.

Why do Insurance companies provide different coverage for their members? 

Each plan is individual to the member. Insurance companies can have many different plans. For example, we have seen Blue Cross cover as little as 10% of sessions and up to 100% coverage.

 

What if my plan covers 100%? 

Yay!  You won’t have to pay anything!

IMPORTANT: In order for us to be able to direct bill for you we require a Visa or MasterCard number to be held on file.

 

What if I have several insurance plans?  Can you help coordinate them?

We will only direct bill to one insurance company at a time. For example, if you have 2 Blue Cross plans, then we can coordinate benefits for you. However, if you have a primary plan with Blue Cross and a secondary plan with Great West Life, then unfortunately, we do not offer any coordination of benefits. You will have to submit your receipt for the balance of the appointment cost to the other plan provider on your own.

 

Do I get a receipt if you direct bill for me? 

You will get a receipt only for the portion that you pay.  For example, if you have 100% coverage, you will not get a receipt.  If you have 80% coverage, you will get a receipt for the 20% remaining balance that you pay, but will include a portion displaying what portion was paid for by insurance, as you may use his statement for your own coordination of benefits.

 

Do insurance companies pay for missed appointment charges?  

No, insurance companies do not cover missed appointment charges.