Motor Vehicle Accident Insurance Direct Billing Policy

Radix Pain & Rehabilitation Centre offers direct billing for eligible motor vehicle accident treatment claims in Alberta. Direct billing is provided as a convenience; however, patients remain responsible for ensuring that their insurance information is complete and accurate and that their insurer pays amounts owing for treatment.

Please read this policy carefully before agreeing to direct billing for motor vehicle accidents.

Information Required for MVA Direct Billing

Before our office can submit invoices or clinical documents, you must provide complete and accurate claim information, including:

Your automobile insurance company
Your policy number
Your claim number
The date of the accident
The full name of your bodily injury claims adjuster
Your adjuster’s telephone number
Your adjuster’s fax number
Your adjuster’s email address, when available

We specifically require the fax number for the bodily injury adjuster responsible for your treatment claim. A general insurance company fax number, a property damage adjuster, a vehicle repair adjuster, or a broker contact is not sufficient.

Incomplete or incorrect information may delay billing, insurer authorization or payment.

Your Responsibility for Insurance Information

Our office submits invoices and required documents based on the information you or your insurer provides.

You are responsible for:

Providing accurate insurance and adjuster information
Informing us promptly if your adjuster or claim information changes
Confirming that your insurer has received the required documents
Responding to requests from your insurance company
Contacting your adjuster when payment has been delayed
Paying amounts that are not covered or paid by your insurer

Acceptance of direct billing does not guarantee that an insurer will approve treatment, reimburse every service or pay an invoice within the expected period.

Secure Transmission of Claim Information

Invoices and clinical documents containing personal or health information will be transmitted using communication methods our clinic deems appropriate for the information involved, in accordance with Alberta Privacy legislation requirements.

Our office ordinarily uses fax to send invoices, treatment plans and clinical documentation to automobile insurers. Standard unencrypted email may not provide an appropriate level of protection for sensitive health information.

Patients must provide a working fax number for the bodily injury adjuster handling their treatment claim.

Insurance Payment Window

Our office allows the insurer 30 days from the date an invoice is delivered to process and issue payment.

Our fax system records whether a transmission has been successfully delivered. This confirmation may be used to establish when an invoice or payment request was sent.

During this period, patients should continue to monitor their claim and respond promptly to communications from their insurer.

Final Payment Notice

If payment is not received within 30 days, our office will send a final payment notice to the insurer.

The patient will also receive copies of:

The original invoice or payment request
The fax delivery confirmation
The final payment notice
The confirmation showing that the final notice was delivered

Once a final notice has been issued, the patient is expected to contact the adjuster directly and determine why payment has not been made.

Our office will allow an additional 14 days from the date of the final notice to resolve the outstanding account, or will proceed to charge the balance owing to the credit card associated with the file. The patient will then be responsible for obtaining reimbursement directly from their insurer.

Administrative Fee for Unresolved Accounts

If payment is not received within 14 days of the final notice, a $50 weekly administrative fee may be charged to the credit card on the patient’s account.

The administrative fee may continue weekly until:

The insurer pays the outstanding account;
The patient pays the outstanding balance, or
The patient makes alternative payment arrangements acceptable to the clinic.

This fee is separate from the cost of treatment. It is intended to offset the additional administrative work involved in repeatedly tracing overdue invoices, resending documents and communicating with insurers regarding unpaid accounts.

Patient Responsibility for Unpaid Treatment Fees

Direct billing does not transfer ultimate financial responsibility from the patient to the clinic.

The patient remains responsible for treatment fees when:

The insurer denies or limits coverage
Benefits have been exhausted
The insurer requires information that has not been supplied
Incorrect claim or adjuster information was provided
The patient does not cooperate with the insurer’s claim process
Another clinic has used available treatment benefits
The claim has been closed
The insurer does not pay the account
A service is not eligible for reimbursement

Patients may choose to pay an outstanding balance directly and seek reimbursement from their insurer when appropriate.

Coordinating Treatment Between Providers

Motor vehicle accident treatment limits may apply across multiple healthcare providers.

You must tell our office when you are receiving accident-related treatment from another chiropractor, physiotherapist, massage therapist, acupuncturist or other clinic. Failure to disclose treatment received elsewhere may result in benefit limits being exceeded.

When an insurer declines payment because available benefits have already been used at another clinic, the outstanding balance remains the patient’s responsibility.

Why This Policy Is Necessary

Insurance direct billing requires considerable administrative work. When invoices remain unpaid, our team must spend additional time confirming delivery, resending documents, contacting adjusters and responding to insurer requests.

This policy establishes a clear and consistent process while allowing our clinic to continue offering direct billing for motor vehicle accidents to eligible patients.

We appreciate your cooperation in providing accurate information, monitoring your claim, and promptly contacting your insurance representative when a payment issue arises.

Questions About Your Insurance Claim

Coverage, authorization and payment decisions are made by your insurance company—not by Radix Pain & Rehabilitation Centre.

Questions about your benefits or the status of an unpaid claim should be directed to the bodily injury adjuster assigned to your file.

For questions about our clinic’s billing policy, please email the Radix Pain & Rehabilitation Centre.