What direct billing actually covers
Extended health plans, explained the way we wish insurers explained them: in one page, without acronym fog.
Devon Okafor, Registered Massage Therapist
September 2025 · 4 min read
Direct billing means we send the claim to your insurer while you are still putting your coat on, and you pay only what the plan does not cover. It is the least glamorous thing we offer and possibly the most appreciated. Here is how to read your own plan before your first visit.
Find three numbers in your plan and you can predict every receipt.
The three numbers that matter
Every paramedical benefit hides three numbers. The per-visit maximum: how much of each appointment the plan pays, sometimes a dollar cap, sometimes a percentage. The annual maximum: the total pool per category per year, commonly a few hundred dollars per discipline. The reset date: usually January 1, sometimes your plan's anniversary. Find those three and you can predict every receipt.
Where people get surprised
Massage, physiotherapy, counselling, and acupuncture usually sit in separate pools, so exhausting one does not touch another. Some plans want a doctor's note for massage before they reimburse: check before your first visit, not after. And counselling coverage often specifies which designations qualify; Registered Clinical Counsellor is widely included, but the wording matters.
What we do at the desk
Bring your policy and member numbers once and we keep them on file. We submit while you are still in the building, tell you the uncovered portion on the spot, and hand you receipts for anything you want to claim on a spouse's plan. If a claim bounces, we investigate before you have to.