Sources: TELUS Health: insurer responses and payments; Pacific Blue Cross: provider direct billing.

Check coverage and payment separately

Start with your benefits plan: is the service covered, is this practitioner eligible, and how much of your benefit remains? Then ask the clinic whether it can submit this particular claim.

TELUS Health notes that some insurers or patient plans do not permit payment directly to the provider. In that situation, being able to submit an electronic claim does not necessarily mean you can leave without paying the clinic.

Sources: TELUS Health: insurer responses and payments.

Five questions for the clinic

  1. Do you offer direct billing to my insurer for this practitioner and service?
  2. Can the insurer pay you directly, or does reimbursement go to me?
  3. What information and consent do you need before the appointment?
  4. What will I need to pay if only part of the fee is covered?
  5. What happens if the claim cannot be processed at the visit?

Ask about the exact branch and practitioner you are booking. A general statement on a clinic website may not answer the details of your appointment.

Four questions for the insurer

  • Are the service and practitioner eligible under my plan?
  • Is a referral required?
  • What deductible, percentage, per-visit limit and annual balance apply?
  • Can payment go to this provider, and how do I claim if it cannot?

Use your plan booklet or member support for these answers. Our insurer instructions show where to check coverage with Sun Life, Manulife, Canada Life, Pacific Blue Cross, GreenShield and Desjardins. Each employer's plan can differ.

An example of a partial payment

Suppose an appointment costs $140, but only $100 of the fee is eligible. At 80% coverage, with enough benefit remaining and no deductible, the plan pays $80 and you pay $60. The percentage applies to the eligible fee, not automatically to the full bill.

These figures are illustrative. See the worked cost examples for the effect of a low balance or a deductible. If reimbursement goes to you, the clinic may require the full fee upfront.

Sources: Sun Life: checking coverage on the web and mobile; TELUS Health: insurer responses and payments.

Bring the details through the clinic's secure process

Ask reception how to provide your insurer name, policy or group number, member identification and any required documentation. Use the clinic's intake or billing process for personal insurance information.

If you pay upfront, request an itemized receipt and check your insurer's claim-submission process and deadline. Check the claim status in your insurer's portal before submitting the same expense yourself; reception may already have submitted it. Keep the receipt even if the clinic submits a claim for you.

MSP supplementary benefits use a separate eligibility and billing process. See how MSP coverage works if that is the benefit you intend to use. Knead helps you find openings; confirm billing arrangements with the clinic.

Sources and scope

This guide explains booking and payment questions. Your clinic confirms appointment eligibility; your insurer or Health Insurance BC confirms benefits. Sources were checked on 2026-10-12.