Course Description

Have you ever felt overwhelmed or confused about direct billing extended health benefits? Whether you're brand new to direct billing or just need some additional guidance, this course is a must! You will be guided step-by-step on how to direct bill to over 40 insurance companies; we cover important topics such as pre-determination, adjudication, coordination of benefits, consent forms, reconciliations and much more. This course is appropriate for any health and wellness practitioners or clinic administrators across Canada. Please note this course does not cover MVAs or WCB claims. 

Learning Outcomes

By the end of this course you will:

  • Be able to weigh the benefits and drawbacks to offering direct billing in your practice, and debunk myths and misunderstandings about direct billing.

  • Understand the ethics of billing and the risks of fraud.

  • Know which insurance companies allow direct billing.

  • Understand how to register with each of the primary insurance portals in Canada.

  • Understand how to pre-determine eligibility, and submit insurance claims for direct billing.

  • Be able to compare the specific rules for each company.

  • Understand coordination of benefits.

  • Know how to keep proper documentation.

  • Be equipped with troubleshooting ideas for when problems arise.

  • Know how to track payments and reconcile your billing records.

Continuing Education Credits

The following associations have approved this course for continuing education credit. Credit may also be available from those associations with no formal approval process.

Pending Approval

AMQ, CMTNB, CMTNL, CMTPEI, CRMTAMTAMMTAS, RMTSMB, RMPQ, RMQ

Approved

NHPC - 5 Credits; CMMOTA - 1 Credit; MTAA - 1 Secondary Credit; MTANS - 1 Secondary Credit

Exclusive Handouts

  • Direct Billing Company Rules

    This master sheet contains rules and other valuable information for 40 insurance companies. Having all of this information compiled into one place is essential to anyone looking to streamline their direct billing processes.

  • Provider Summary

    This valuable handout summarizes which health and wellness practitioners/providers are authorized to direct bill for each of the 40 insurance companies identified in the master sheet.

Course Curriculum

  • 1

    Introduction

  • 3

    Chapter 2: The Ethics of Direct Billing

    • Ethics

  • 4

    Chapter 3: Getting Set Up

    • Which Insurance Companies Direct Bill?

    • Master Sheet and Provider Summary Downloads

    • Direct Deposit

    • Insurance Brokers

    • Portal Registration Introduction

    • Telus eClaims Registration

    • Provider Connect Registration

    • claimsXchange Registration

    • Medavie Blue Cross Registration

    • RWAM Registration

    • BenefitsXchange/Sirius Benefits Registration

    • Provincial Portals - Registration Instructions

  • 5

    Chapter 4: Before your Client Arrives

    • Policy Numbers and Common Questions

    • Pre-determination

    • Doctor’s Notes

    • Coordination of Benefits

  • 6

    Chapter 5: Completing a Claim

    • Obtaining Client Permission

    • Claim Submission Introduction

    • Telus eClaims

    • Provider Connect

    • claimsXchange

    • Medavie Blue Cross

    • RWAM

    • BenefitsXchange/Sirius Benefits

    • Provincial Portals - Submission Instructions

  • 7

    Chapter 6: Workflow

    • Workflow

  • 8

    Chapter 7: Specific Rules for each Company

    • Specific Rules

  • 9

    Chapter 8: When Problems Arise

    • Claim Doesn’t Go Through

    • Getting Audited

    • Clients Who Don’t Pay

    • Cancelling a Claim

    • Frequently Asked Questions

  • 10

    Chapter 9: Accounting

    • Payment Tracking and Reconciliation Process

  • 11

    Conclusion

    • Key Takeaways

    • Quiz

    • References

Course Certificate

After successful completion of this course, you will receive a course certificate stating that you've completed 2 hours of online training.

Instructor

Melissa Pierson, RMT

Melissa is a Registered Massage Therapist and the founder of the Online Wellness Institute. She graduated with honours in 2009 from CCMH Foothills College of Massage Therapy, and was chosen to be the valedictorian of her graduating class. Her courses focused on anatomy and physiology, pathology, advanced massage treatments, hydrotherapy, and biomechanics. After graduation, Melissa returned to CCMH as a case study panel member, where she reviewed and marked case studies. Melissa published an award winning case study in the International Journal of Therapeutic Massage and Bodywork on the effects of massage therapy on Temporomandibular Joint (TMJ) dysfunction symptoms. She has also completed advanced training on assessing and treating the TMJ.

Making sense of DIRECT BILLING begins here

Only $47.25 (including tax)