Insurance Coverage Billing

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WORKERS COMPENSATION BOARD (WCB)

Have you been injured during work?

If you have injured yourself at work, informed your employer, and need to file a claim through the Worker’s Compensation Board, and inform them of the accident that took place.

Both you and your employer are required to complete and submit WCB Reports. You can easily submit your Worker’s Report of Injury online at www.wcb.ab.ca.

Our physiotherapists and staff are very experienced with WCB procedures, and have seen many cases of workplace injuries.

WCB always covers the initial visit, and first treatment cost. Further approval could be based on the severity of your injury, along with the length of time you may be approved for treatments.

WCB usually approves up to a maximum of twenty-one (21) treatments over a maximum of six (6) consecutive calendar weeks

Book an Appointment

MOTOR VEHICLE COLLISION INSURANCE (CAR ACCIDENTS)

What to do if you are involved in a motor vehicle accident:

1
Inform your insurance company
Whether you were a driver, or passenger at the time of the incident. You need to file an injury accident report to your insurance company, this will open up a motor vehicle claim that will help you get the treatment you need.
2
Get assessed by your physiotherapist
Schedule an assessment with your physiotherapist as soon as possible, our staff and physiotherapist will submit (AB-1, AB-2) report to your auto insurance company, and determine a treatment plan based on your injuries. Your physiotherapist will help insure you are covered in protocol treatments.
3
Know your rights
Your personal auto insurance company may refer you to their preferred physiotherapy clinic, but you have the right to choose your own therapist, and a clinic you trust. Our clinic is specialized in direct billing to all auto insurance companies, and works very closely with them to provide you the best service, and treatments, in order to get you back on your feet.

Have questions about your coverage? Email us at info@instepphysio.ca or give us a call at 587-409-1754

 

PHYSIOTHERAPY INSURANCE COVERAGE

How to make the most of your physiotherapy insurance:

1
Check Your Plan Details
Every plan is different. Some cover a set dollar amount per year, while others provide a maximum number of visits. Reviewing your plan helps avoid surprises and ensures you can plan your treatments accordingly.
2
Annual Reset
Most benefit plans reset annually, and unused coverage often does not carry forward. Scheduling care throughout the year helps you maximize what you’re entitled to.
3
Treatment Categories
Some plans include specialized services like pelvic floor care, vestibular rehab, pediatric physiotherapy, or acupuncture, in addition to standard physiotherapy.

DIRECT BILLING

Taking the stress out of payments:

1
We Bill Your Provider
Our clinic offers direct billing to most major insurance companies, including Blue Cross, Sun Life, Manulife, Green Shield, and many others. This means claims are submitted on your behalf.
2
Split Payments Simplified
Your insurer pays their portion directly, and you only cover what’s left at the time of your visit; no waiting weeks for reimbursement.
3
No Extra Paperwork
Direct billing eliminates the need to manage receipts or submit claims yourself, saving you time and effort.

HEALTH BENEFIT COVERAGE

Understanding how health benefits work for you:  

1
Employer and Private Plans
Extended health benefits are often offered through workplace plans or purchased privately. They usually include physiotherapy as part of overall health coverage.
2
Flexible Use of Coverage
Benefits can often be used across different treatment areas, allowing you to address multiple concerns such as injury recovery, chronic pain, or mobility issues.
3
Budgeting Your Benefits
Many patients spread visits across the year to maintain steady progress while staying within their annual coverage limit.

INSURANCE-COVERED PHYSIOTHERAPY

Types of care often included under insurance:  

1
Workplace Injuries
Coverage may apply to injuries sustained on the job, sometimes in addition to WCB support.
2
Motor Vehicle Accidents
Treatments for accident-related injuries are commonly covered under auto insurance protocols, helping you recover quickly.
3
Covered Situations
Many plans cover workplace injuries, auto accident rehab, and routine physiotherapy for recovery after surgery, illness, or daily aches and pains.

INSURANCE BILLING

How we simplify the process for you:  

1
Eligibility Review
Before treatment starts, we confirm what your plan covers and how much is reimbursed per session.
2
Claim Submission
Billing is processed directly with your provider, ensuring faster turnaround and fewer delays in starting treatment.
3
Clear Communication
Any portion not covered is explained upfront, so there are no hidden fees or surprises.

NO REFERRAL NEEDED

Understanding how referrals work for physiotherapy coverage:    

1
Direct Access
Most insurance providers allow you to see a physiotherapist without a physician referral, making it easier to start treatment quickly.
2
Exceptions May Apply
Some plans or extended health benefits may still require a referral. If this is the case, we’ll let you know what’s needed.
3
We Guide You
Our staff will confirm with your insurance provider if a referral is required, so there are no surprises.

COORDINATION WITH INSURANCE PROVIDERS

How we work with your insurance company to keep care stress-free:  

1
Submitting Reports
Some insurers require updates, such as progress notes. Our team provides this documentation on your behalf.
2
Treatment Approvals
Some plans or extended health benefits may still require a referral. If this is the case, we’ll let you know what’s needed.
3
Continuity of Care
We take care of communicating with insurers to help ensure your treatment continues without delays or interruptions.

SECONDARY INSURANCE COVERAGE

Making the most of dual health plans: 

1
Coordination of Benefits
If you and your spouse both have health coverage, you may be able to combine them to increase your reimbursement.
2
Primary vs. Secondary Plans
One plan pays first, and the other can cover remaining costs. Our staff will guide you through which plan to bill first.
3
Maximized Coverage
This process helps reduce your out-of-pocket expenses and ensures you use your full benefits.

OUT-OF-POCKET PAYMENTS & TAX RECEIPTS

Options if your coverage doesn’t cover everything: 

1
Easy Payment Options
If coverage doesn’t cover everything, you can pay securely at the clinic, and we’ll provide receipts you can submit or use for tax claims.
2
Detailed Receipts
We provide clear receipts for all payments made out-of-pocket.
3
Tax Claim Eligibility
Many physiotherapy expenses not covered by insurance can be claimed as medical expenses during tax season.

COVERAGE FOR STUDENTS, SENIORS, AND LOW-INCOME PROGRAMS

Different groups may have unique access to benefits:  

1
Students
Many universities and colleges in Alberta include physiotherapy under student health plans, often with partial coverage for sessions.
2
Seniors
Retirees may have physiotherapy included in private health plans or extended coverage through retirement benefits.
3
Community and Employer Plans
Some community-based and employer group plans include physiotherapy benefits, making care more accessible across different life stages.

PRE-AUTHORIZATION AND CLAIM LIMITS

Understanding when pre-approval is required: 

1
No Pre-Approval for Most Plans
Many extended health insurance providers allow you to begin physiotherapy without prior authorization.
2
When It’s Needed
Certain insurers may request pre-authorization for longer treatment plans, particularly when the injury is complex or requires multiple visits.
3
We Assist With Approvals
If pre-authorization is required, our team helps submit the necessary forms and updates to keep your care on track.

INSURANCE FOR FAMILY COVERAGE

How can benefits extend to your loved ones: 

1
Dependents Included
Many insurance plans cover spouses and children under the same policy, making physiotherapy accessible for the whole family.
2
Pediatric Care Options
Parents can often use their plans to access pediatric physiotherapy for children recovering from injuries or developmental concerns.
3
Shared Benefits
Family members may share the same annual physiotherapy allowance, depending on the details of the policy.

INSURANCE & SAME-DAY APPOINTMENTS

Coverage applies even when you need care quickly: 

1
Urgent Visits Covered
Insurance benefits apply to same-day and short-notice appointments the same way as scheduled visits.
2
No Extra Fees
There are no additional insurance restrictions for accessing urgent physiotherapy care.
3
Convenience and Flexibility
Patients can use their benefits whenever they need, whether it’s a planned program or an immediate appointment for new pain or injury.

IS PHYSIOTHERAPY COVERED BY ALBERTA HEALTH CARE (AHC)?

Clarifying Alberta Health Care coverage:  

1
Not Offered at Our Clinic
In Step Physical Therapy is not an Alberta Health Services (AHS)-funded provider. Sessions here are billed through private insurance, workplace coverage, or out-of-pocket.
2
Limited AHS Coverage
AHC funding only applies in specific cases, such as post-hospital discharge programs at select AHS facilities.
3
Alternative Options
For most patients, physiotherapy is accessed through extended health benefits, WCB claims, or motor vehicle accident coverage.

STEP-BY-STEP GUIDE TO USING INSURANCE AT OUR CLINIC

A simple process to make billing stress-free:  

1
Book Your Appointment
Call or schedule online to get started.
2
Bring Your Insurance Details
Provide your policy information during your first visit.
3
Confirm Your Coverage
At your first visit, we review your plan details with you, so you know exactly what’s included moving forward.
4
We Handle the Billing
Claims are submitted directly to your provider.
5
Pay Any Remaining Balance
If your plan doesn’t cover the full cost, you’ll only pay the difference at the clinic.

FAQ’s

Physiotherapy Insurance Coverage in Edmonto

1. Is Physiotherapy Covered by Insurance in Edmonton?

Yes. Many extended health benefit plans in Edmonton cover physiotherapy sessions. Coverage usually includes both the first assessment and follow-up sessions, but the amount depends on your individual plan. 

2. How Many Physiotherapy Sessions Are Usually Covered by Insurance?

The number of sessions depends on your plan. Some policies offer a yearly dollar maximum, while others limit the number of visits you can attend. 

3. Does Insurance Cover Both Assessment and Treatment Sessions in Physio?

Most plans cover both. Sometimes the coverage is split, with different limits for assessments and follow-up visits.

4. What Happens if My Physiotherapy Sessions Go Beyond My Insurance Limit?

 If you reach your limit, you can continue care as a self-pay client. Some people also use a Health Spending Account (HSA) if they have one. 

5. Does Extended Health Care Pay for All Physiotherapy Costs?

Extended health care usually covers part of your session fee. Any amount not paid by insurance is your responsibility.

6. Will My Insurance Cover Physiotherapy if I Have a Pre-Existing Condition?

Yes. Most insurers cover physiotherapy as long as it’s considered medically necessary and falls under your plan's benefits. 

7. Does Insurance Cover Physiotherapy for Chronic Conditions?

 Yes. Coverage usually includes both short-term injuries and long-term conditions such as arthritis or mobility challenges. 

8. Does Insurance Coverage for Physiotherapy Reset Every Calendar Year?

 Most policies reset yearly, either on January 1 or on your policy renewal date. Check with your provider to confirm. 

9. Can Physiotherapy Be Claimed Under Preventive Care?

Some plans allow physiotherapy for prevention and general wellness, while others require an injury or condition.

10. Does Direct Billing Apply for Physiotherapy Sessions?

 Yes. At In Step Physical Therapy, direct billing is available for most major insurers, meaning we bill them directly for you.

11. How Does Direct Billing Work for Physiotherapy Clinics?

The clinic submits your claim directly to the insurer. The insurer pays its portion, and you only pay any remaining balance.

12. Do All Physiotherapy Clinics Offer Direct Billing in Edmonton?

 No. Not every clinic offers this service. At In Step, we do provide direct billing to make things easier for clients.

13. What Is the Difference Between Direct Billing and Submitting Claims Myself?

With direct billing, the clinic handles the paperwork. Without it, you pay in full after your session and submit receipts to your insurer for reimbursement.

14. What Information Do I Need to Provide for Insurance Billing at Physiotherapy Clinics?

Usually, you need your insurer’s name, policy number, and ID number. Some insurers may also ask for a referral.

15. Can I See the Coverage Amount Before Booking a Physiotherapy Session?

 Yes. We can check your benefits in advance so you know what portion is covered and what you’ll be responsible for.

16. What Happens If My Insurance Claim Is Denied After a Physiotherapy Session?

If denied, you’ll need to cover the session fee. We provide detailed receipts and can help you with resubmission if needed.

17. What Happens If My Insurance Covers Only Part of the Physiotherapy Cost?

 You’ll pay the remaining balance not covered by your plan.

18. Do Health Benefits Cover Physiotherapy Without a Doctor’s Referral?

Many insurance plans allow you to book physiotherapy directly, while a few may still require a referral. Confirming with your insurer ensures there are no surprises.

19. Can I Choose My Own Physiotherapist if I Am Using Insurance Coverage?

Yes. Even if your insurer suggests a clinic, you can choose where to go.

20. Can Physiotherapy Near Me Be Claimed Through Work Health Benefits?

 Yes. Workplace health plans typically allow you to use coverage at any registered clinic.

21. Will My Insurance Cover Physiotherapy if I Am a Student?

Yes. Many student plans include coverage for physiotherapy.

22. Can My Insurance Cover Physiotherapy for Children or Seniors?

Yes. Most plans cover physiotherapy for all dependents listed on the policy.

23. Can I Split Physiotherapy Coverage Between Multiple Clinics?

 Yes, as long as each clinic is staffed by licensed physiotherapists and bills under physiotherapy benefits.

24. Can I Use Insurance Coverage for Both In-Clinic and Home Visits?

Some plans allow this, but others restrict coverage to in-clinic sessions.

25. Will My Insurance Cover Multiple Physiotherapy Appointments in the Same Week?

 Yes, as long as it’s medically necessary and you still have benefits left.

Coverage Through Different Programs

26. Does Car Accident Insurance Cover Physiotherapy Sessions in Alberta?

 Yes. If you’ve been in a motor vehicle accident, auto insurance will cover your physiotherapy under treatment protocols.

27. How Does WCB Coverage Work for Physiotherapy Treatments?

If your injury happened at work and is approved by WCB, they typically cover the assessment and an approved number of follow-ups.

28. Can I Use Both WCB and Private Insurance for Physiotherapy?

No. If WCB has accepted your claim, they are the main payer, and private insurance cannot be billed for the same sessions.

29. Can I Use Both Auto Insurance and Extended Health Benefits for Physiotherapy?

 Yes. Auto insurance is billed first. Once that coverage ends, you can use your extended health plan.

30. What Is the Difference Between WCB and Private Insurance Coverage for Physiotherapy?

 WCB applies to workplace injuries and covers a set number of sessions. Private insurance covers other injuries or ongoing care based on your policy limits.

31. Can I Switch to Private Insurance if WCB or Auto Insurance Ends?

Yes. Once WCB or auto coverage finishes, you can continue care using your extended health plan.

32. Can I Claim Physiotherapy Under Health Spending Accounts (HSA)?

 Yes. HSAs typically include physiotherapy as an eligible expense.

33. Do Travel Insurance Policies Ever Cover Physiotherapy Sessions?

 Sometimes, if the injury happened while travelling and treatment is part of your medical claim.

34. What Insurance Companies Cover Physiotherapy in Edmonton?

 Most major insurers cover physiotherapy, including Alberta Blue Cross, Sun Life, Manulife, Green Shield, Desjardins, Canada Life, and Empire Life.

35. Does Alberta Blue Cross Cover Physiotherapy in Edmonton?

 Yes. Coverage varies by plan, but many include assessments and follow-ups. Direct billing is available.

36. Does Sun Life Insurance Cover Physiotherapy in Alberta?

Yes. Sun Life generally covers physiotherapy under extended health benefits, with limits depending on your policy.

37. Does Manulife Cover Physiotherapy Services in Edmonton?

 Yes. Manulife usually includes physiotherapy. We can confirm your details and bill directly when possible.

38. Does Canada Life Insurance Pay for Physiotherapy Sessions?

 Yes. Coverage amounts and visit limits depend on your individual plan.

15. Can I See the Coverage Amount Before Booking a Physiotherapy Session?

 Yes. We can check your benefits in advance so you know what portion is covered and what you’ll be responsible for.

39. Does Green Shield Canada Cover Physiotherapy in Alberta?

 Yes. Green Shield typically provides a set dollar amount or number of sessions per year.