Direct Billing for Psychotherapy

Less Paperwork.
One Less Thing to Manage.

Heart & Mind Therapy offers direct billing to many insurance providers for psychotherapy sessions, when your plan allows it.

When direct billing is available, we can submit your eligible claim to your insurance provider after your session. Depending on your plan, your insurer may cover all or part of the session fee, and you would be responsible for any remaining balance.

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Direct Billing for Psychotherapy

We can take care of the insurance claim for you.

If your insurance plan allows direct billing for psychotherapy, Heart & Mind Therapy can submit an eligible claim to your insurer after your session.

If your insurer pays only part of the session, you pay the remaining balance. If your plan does not allow us to bill directly, we will provide you with a receipt so you can submit the claim yourself.

What Direct Billing Means

We Submit your eligible psychotherapy claim

Direct billing can save you from paying the full session fee upfront and submitting the insurance paperwork yourself, when your plan supports this option.

✓ We submit eligible claims on your behalf
✓ Your insurer determines what your plan covers
✓ You pay any amount that is not covered
✓ Receipts are available when you need to submit your own claim

How It Works

Direct billing is fairly simple.

You provide your insurance information, attend your session, and we submit the eligible claim through the appropriate billing system when direct billing is available.

01

Give Us Your Insurance Information

We need the plan and member information required by your insurer before we can attempt to submit a claim on your behalf.

02

We Submit the Claim

After your session, we submit the claim electronically when your insurer, your plan and your therapist are eligible for direct billing.

03

You Pay the Remaining Balance

If your insurer covers part of the session, you are responsible for the portion that remains. If the claim cannot be billed directly, the session fee remains payable and we can provide a receipt for you to submit.

?

Direct billing is not the same as guaranteed coverage.

We can submit a claim, but your insurance company makes the final decision about eligibility, coverage and payment. Your benefits are determined by the specific plan you have through your employer, school, association or private insurer.

Direct Billing

Sun Life Financial Eligible claims may be submitted through Sun Life’s provider eClaims system.
TELUS Health eClaims An electronic claims platform used to submit eligible claims to a number of participating Canadian insurers.
providerConnect A provider portal used by participating benefit carriers, administrators and third-party payors.
Blue Cross Eligible claims may be submitted electronically where the applicable Blue Cross plan and provider system allow it.

Insurance & Billing Networks

We work with several direct-billing systems.

AVAILABILITY DEPENDS ON YOUR INDIVIDUAL PLAN

Heart & Mind Therapy can submit eligible psychotherapy claims through several electronic billing systems, including Sun Life Financial, TELUS Health eClaims, providerConnect and Blue Cross provider systems.

These systems connect clinics with different insurers and benefit plans. Being able to submit through a particular system does not mean that every plan within that system will cover psychotherapy, every therapist credential, or the full cost of your session.

If you are unsure about your plan, check with your insurer before your first appointment. We are happy to provide the information about your therapist that you may need when asking about coverage.

Know Your Coverage

Your insurance plan decides what gets covered.

Two people can have insurance through the same company and have very different psychotherapy benefits. Your employer or plan sponsor chooses the benefits included in your particular plan.

Before beginning therapy, we recommend confirming your coverage directly with your insurer. This is especially important if the cost of therapy will affect how often you are able to attend.

Is psychotherapy covered? Confirm that your plan includes mental-health or psychotherapy services.
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Which professional credentials are covered? Some plans cover Registered Social Workers, Registered Psychotherapists or other professionals differently.
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How much does your plan pay? Ask about your reimbursement percentage, per-session limits and annual maximum.
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Is direct billing permitted? A plan may cover therapy while still requiring you to submit the claim yourself.
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Are there other requirements? Ask whether your plan has a deductible, referral requirement or other condition that applies to your claim.
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Before Your First Session

Five questions to ask your insurance company.

A quick call or message to your insurer can prevent surprises later. Have the name and credentials of the therapist you plan to see available when you contact them.

1. Is My Therapist’s Credential Covered?

Ask whether your plan covers the professional designation of the therapist you are planning to see.

2. What Percentage Is Covered?

Some plans reimburse the full eligible amount while others cover only a percentage of each session.

3. What Is My Annual Maximum?

Ask how much coverage you have available each benefit year and whether you have already used part of that amount.

4. Is There a Per-Session Limit?

Your plan may limit the amount it will reimburse for each appointment even when psychotherapy is covered.

5. Can My Provider Bill Directly?

Ask whether your particular plan allows benefits to be assigned to the therapist or clinic through direct billing.

Keep Your Benefits Information Handy

We need accurate plan and member information to attempt electronic claim submission on your behalf.

Important to Know

What if direct billing doesn’t go through?

A rejected, pending or unavailable direct-billing claim does not necessarily mean that you have no insurance coverage. Sometimes the claim simply needs to be submitted by the plan member instead.

If we cannot bill your plan directly, you remain responsible for the session fee. We can provide a receipt with the information you need to submit your claim to your insurer yourself.

Coverage Cannot Be Guaranteed Insurance coverage is determined by your insurer and your individual benefits plan. Heart & Mind Therapy cannot guarantee that a claim will be approved or reimbursed.
Direct Billing Is a Convenience Our ability to submit a claim on your behalf does not confirm that the service, therapist or full session fee is covered by your plan.
You Are Responsible for Unpaid Amounts Clients are responsible for session fees and for any balance that is not paid by their insurer, including claims that are declined, reversed or otherwise unpaid.
Your Benefits Can Change Coverage limits, eligibility and plan rules can change. We recommend checking your benefits directly with your insurer rather than relying on previous claim results.
About insurance information: By requesting direct billing, you authorize the information required for the claim to be submitted to the applicable insurer or claims administrator. Please review Heart & Mind Therapy’s consent and privacy information for details about how personal health information is handled.

Important: Heart & Mind Therapy can assist with claim submission, but we do not administer or control your insurance plan. Information provided by the clinic about direct billing should not be treated as confirmation of coverage. Clients are responsible for understanding their own benefits and for confirming coverage, eligibility, limits and other plan requirements directly with their insurer.

Ready to Get Started?

Use your benefits without making therapy more complicated.

Book a free 20-minute consultation to find a therapist who fits what you’re looking for. If you plan to use insurance, you can also ask us what information you may need to confirm your coverage before your first session.

Book My Free 20-Minute Consultation