BPA
At this time, this payer is not providing real-time adjudication, so all claim requests will come back with a “claim pending” response. Therefore, claim submission is only available with the option “payable to” the patient. Please ensure you collect the full treatment amount from your clients covered by this insurer.
A response following a claim acknowledgement is usually processed within a week. Predeterminations and rejected claims are mailed to providers daily, and cheques along with explanation of benefit statements for payable claims are mailed on the 1st and 15th of each month.
At this time, this payer is not providing real-time adjudication, so all predetermination requests will come back with a “claim pending” response.
No, the payment is limited to insured members.
You must always obtain payment from your client for services rendered. This insurer always issues payment for insured expenses directly to its members, in accordance with the method of payment applicable to their plan.
No.
Only one treatment per day for the same procedure code is eligible.
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Acupuncturists (Only allowed if the acupuncturist is registered with the College of Traditional Chinese Medicine)
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Chiropodists
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Chiropractors
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Dietitians
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Massage therapists
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Naturopathic doctors
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Occupational therapists
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Osteopaths
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Physiotherapists
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Podiatrists
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Psychologists
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Psychotherapists
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Social workers
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Speech-language pathologists