Direct insurance billing in Canada:
a complete guide for allied health practitioners

If you've ever watched a client dig through their wallet for a credit card, promise to submit their own insurance claim, and then quietly never rebook — you already understand why direct billing matters.

Direct insurance billing means your clinic submits the insurance claim on behalf of the client at the time of service. The insurer pays your clinic directly for the covered portion, and the client pays only the remainder — their deductible or anything above their annual coverage limit. No paperwork for the client. No waiting for reimbursement. No friction between the treatment and the next booking.

How extended health benefits work in Canada

Most Canadians with employer-sponsored benefits have extended health coverage that includes paramedical services — physiotherapy, massage therapy, chiropractic, acupuncture, naturopathy, and more. The specific services covered, the annual dollar limit, and the per-visit maximum all depend on the individual's plan.

In practice, this means:

• A client may have $500 per year in physiotherapy coverage and $400 per year for massage therapy
• Their plan might cover 80% of each visit, leaving a 20% copay for the client
• Unused benefits reset each calendar year — worth reminding clients about in the fall

The major insurers providing extended health benefits in Canada include Sun Life, Manulife, Canada Life (formerly Great-West Life), Blue Cross, Green Shield Canada, SSQ Insurance, and Medavie Blue Cross, among others.

TELUS Health eClaims: the platform you need

TELUS Health eClaims is the primary direct billing platform for allied health practitioners in Canada. By registering once with eClaims, you gain access to submit claims to more than 30 participating insurers — covering the vast majority of privately insured Canadians.

The service is free for practitioners. There is no charge to register, no per-claim fee, and no monthly cost. You submit a claim through the eClaims web portal after the client's appointment, receive an instant response indicating whether the claim is approved and what amount will be paid, and receive payment by direct deposit.

The professions eligible for eClaims include physiotherapists, chiropractors, registered massage therapists, acupuncturists, naturopathic doctors, psychologists, podiatrists, optometrists, and several others. To register, you will need your provincial college registration number. The registration process is completed online at telus.com/eclaims.

Additional platforms to know

Depending on your province and client base, you may also want to register with:

• Claimsecure — used to process claims for Green Shield Canada, SSQ Insurance, and Medavie Blue Cross. Particularly important if you work with Veterans Affairs Canada (VAC) or RCMP members, who have coverage through Medavie.
• Pacific Blue Cross — for practitioners in British Columbia, registering directly with PBC expands your direct billing coverage.
• WSIB — for Ontario practitioners treating workplace injury clients, WSIB billing follows a separate process through the Workplace Safety and Insurance Board.

For most private practices in Ontario, TELUS Health eClaims plus Claimsecure covers the majority of what you'll encounter.

What you need to collect from clients

To submit a direct bill claim, you need the following information from your client at the time of booking or before their first appointment:

• Insurance company name — which insurer holds their plan
• Policy or group number — the employer's group plan number
• Member ID or certificate number — the client's individual identifier
• Date of birth — required for verification
• Explicit written consent — the client must authorize you to submit claims on their behalf

Collecting this information on your intake form saves time at the point of care. Having it in your practice management system means you don't need to ask for it again at every appointment.

What happens at checkout

The direct billing workflow at the end of an appointment is straightforward:

1. Open the eClaims portal (or your practice management software if it integrates with eClaims)
2. Enter the client's service details — date, practitioner, service type, and fee
3. Submit the claim to the insurer
4. Receive an instant response — approved, partially approved, or declined — with the insurer's payment amount
5. Collect the client's portion (their copay or the amount above their coverage)
6. The insurer's portion is deposited directly to your account, typically within a few business days

Why practitioners offer direct billing

The most consistent reason practitioners offer direct billing is client retention. When clients don't have to pay upfront and submit their own paperwork, the barrier to returning is lower.

There is also a practical billing advantage: direct billing through eClaims is processed by direct deposit, which means you receive payment without credit card processing fees on the insurer's portion of the invoice. On a $120 appointment covered 80% by insurance, that's $96 arriving by direct deposit rather than through your payment terminal.

Setting up your software for direct billing

If your practice management software integrates with TELUS Health eClaims, direct billing can happen entirely within your software — without switching between platforms. You submit the claim from the same screen where you create the invoice, and the response comes back automatically.

When evaluating practice management software, it's worth confirming whether the eClaims integration is built in or requires a third-party add-on. An integrated workflow is meaningfully faster in practice, especially on high-volume days.

A note on HST and insurance claims

Most physiotherapy, massage therapy, and chiropractic services provided by regulated health professionals in Canada are exempt from HST — meaning you do not charge HST on those services. When submitting eClaims, you enter the fee for the service; HST does not appear on these claims for exempt services.

If your practice offers any taxable services alongside exempt ones, keep them clearly separated in your invoicing. Confirm your specific situation with an accountant familiar with Canadian healthcare billing.

Getting started