Latest Thinking

Direct Billing to Insurers

September 8, 2016

Making it easier to go back to Chiropractors

Sue Judge
Healthcare Technology Writer

Young or old, fitness enthusiast or couch potato, chronic back pain can strike anyone. And when it strikes, people struggle just to get through the day, often times missing work. Fortunately, many corporate health insurance plans now cover chiropractic services. But additionally, many chiropractors now provide electronic claims submission services which reduce patient out-of-pocket costs, making it easy for them to commit to treatment plans and prevent debilitating flair-ups that can result in missed work.

Easing the pain of healthcare claims

At the end of a chiro appointment, patients typically expect to pay, get a receipt and eventually submit the claim paperwork to the insurance company. But times are changing! Just like pharmacists and dentists, chiropractors can now electronically submit insurance claims on behalf of patients and get a real time coverage response – right at the point-of-care. This means that patients only pay for the amount not covered by their insurance plan and they don’t have to think about submitting paper claims after the service. It is all taken care of before ever leaving the clinic.


 

“Before using eClaims, every client was responsible for paying for their appointment right away. Now that we have the ability to direct bill, it’s very beneficial for the client to only have to pay what is not covered by their plan … The client leaves very satisfied knowing that their claim has been submitted, and they can book their next appointment, as well as budget accordingly.”

Dr. Jaipul Parmar
Chiropractor & Co-owner
Alliance Wellness Clinic
Vancouver, British Columbia

 


The new debit card of healthcare

I decided to take a closer look at how this shift in claim submission came about and educate myself on the evolving role technology is playing in facilitating access to healthcare in Canada. Direct billing started becoming more common in pharmacies. We all likely take for granted that when we go to fill a prescription, we only pay for the amount not covered by our insurance plan. But, this wasn’t always the case. We used to have to pay for the full amount of the prescription cost, and then fill out and submit our insurance claim paperwork for reimbursement. Today, virtually all pharmacies offer direct billing at the point-of-service. The same is true for dentists, and the service has been so well received that many will now switch dentists if they don’t provide direct billing.


 

Web-based direct billing from your tablet or laptop

  • Increase patient satisfaction due to fewer out-of-pocket expenses and less hassle
  • Reduce credit card fees as you only charge clients for their deductible
  • Greater capacity for reporting than with traditional methods
  • Increase payment efficiency through daily updates from the provider database
  • Free service

 


Chiropractors are business people too

Just like any small business owner in any market, chirpractors are responsible for all aspects of their practice, from sales and marketing, to office operations, and everything in between. And to build and manage a successful practice today requires technology. In addition to accounting and customer relationship management (CRM) software, direct-billing services are now making their way into allied healthcare provider clinics nationwide, quickly becoming essential to running an efficient practice and providing a premium client experience.

Driven by an inherent passion for quality customer experiences, more and more chirpractors across Canada are embracing the ease-of-use and cost-efficiencies of direct billing to differentiate their practices, encourage loyalty from clients and simply to facilitate access to services.

How does it work?

Direct billing has come a long way from its early days of complex procedures and expensive software purchases. Leveraging modern cloud technology, today’s direct billing solutions such as TELUS Health eClaims are typically free. A few minutes to register online is all it takes to get up and running – there’s no special hardware or software to purchase and install, there are no extra fees to use the service and, there’s no extensive training to learn how to submit claims either. With an intuitive, easy-to-use interface, eClaims optimizes the claim process with real-time confirmation of client coverage (when supported by the insurance company) resulting in faster payments and increased accuracy compared to the traditional paper submission process.

eClaims Registration
Get up and running in minutes! Access 10 insurers on 1 service, covering 85% of privately insured Canadians. Register at telushealth.com/eclaims

Chiropractors who register for the eClaims service also benefit from being listed on the TELUS Health website and various insurance company plan member portals. Potential clients use these sites to search for eClaims enabled providers in their area. That’s free marketing for eClaims enabled chiropractors.

Clients can commit to the recommended treatment plan

Since there is minimal impact on out-of-pocket expenses, clients are more inclined to keep their appointments. And, because patients are able to access chiropractic services as soon as symptoms flared up, they can immediately improve their physical condition and thus productivity at work without seriously impacting their personal budget. Completing full treatment cycles improves long-term recovery prognosis, allowing patients to better control future flare-ups, minimize the amount of time in pain, and reduce missed work.

The insurer’s point of view

While they play an important role in Canada’s social healthcare ecosystem, the fact remains that private insurers are motivated by cost management of plan sponsor benefit plans, and therefore must consider bottom-line numbers. It is also true, however, that private insurers are competing for customers, and therefore need to differentiate their plans with value-added services such as direct billing which:

  • increase automation
  • accelerate the processing and payment of claims
  • reduce call volume to customer service
  • enhance plan member experience (and therefore plan loyalty)

Not all Canadian insurers offer direct billing as of yet but it is quickly becoming the norm among most major health benefit plan providers.


 

Using the cloud to connect our healthcare system

TELUS Health, one of Canada’s leaders in healthcare technology, believes that technology can have an important impact on transforming healthcare for all Canadians. It can improve health outcomes by connecting doctors and other health practitioners such as massage therapists and chiropractors with one another, with pharmacists and with patients.

For example, with eReferrals, physicians can digitally refer a patient to an allied health professional, such as a massage therapist, and include their notes on the issues and treatment requirements. This eliminates any communication gap by taking the onus of relaying information away from the patient. And, it minimizes the guesswork associated with pinpointing the best treatment, ensuring more rapid rehabilitation.

The switch to electronic processing is already being seen across many healthcare sectors, including remote patient monitoring, electronic medical records (EMR) at physicians’ offices, electronic health records (EHR) at hospitals, and pharmacy management solutions. These initiatives are demonstrating true value to all participants by embracing the cost and productivity efficiencies enabled by today’s ubiquitous cloud networking.

 


What does this all mean?

Direct billing is making it easier for people to access private healthcare services – an important step towards improving the health of Canadians. Access to the right treatment, at the right time not only improves health outcomes, but also makes for a more efficient and focused workforce for employers.

With not as much of a history in offering direct billing services, allied healthcare providers (such as chiropractors) are quickly making up for lost time by leveraging technology to enhance client experience and business operations. They understand that the financial benefits of direct billing services, the capabilities it affords, and the positive word-of-mouth it creates from happy customers are all well worth adapting to a new technology.


 

Who offers direct billing?

Offered through TELUS Health eClaims:

  • Chambers of Commerce Group Insurance Plan
  • Cowan
  • Desjardins Insurance
  • The Great West Life Assurance Company
  • GroupHEALTH
  • GroupSource
  • Industrial Alliance Financial Group
  • Johnson
  • Johnston Group
  • Manion
  • Manulife
  • Maximum Benefit
  • Standard Life
  • Sun Life Financial

Offered Indendently:

  • Alberta Blue Cross
  • Greenshield Canada
  • Medavie Blue Cross
  • Pacific Blue Cross
  • Saskatchewan Blue Cross

 


Register for eClaims in minutes! Access 10 insurers on 1 service, covering 85% of privately insured Canadians. Register at telushealth.com/eclaims

About the author

Leveraging a 20-year history of working for diverse high tech companies, Sue Judge established her own freelance business and for more than 5 years has been writing about IT technology across the healthcare, enterprise and telecom industries.