Insurance Billing

What Insurance Companies Can We Direct Bill 

At Helio Optometry, we understand the importance of convenience and ease in managing eye care expenses. We offer direct billing to most insurance providers to facilitate this, provided your plan supports a direct billing option. This service streamlines the payment process, allowing us to bill your insurance company directly for the cost of your eye care services and products. For clients whose plans do not support direct billing or who prefer to handle their insurance claims personally, we also provide the option to pay in full at the time of service or purchase. In these cases, we will provide you with a detailed receipt, which you can submit to your insurance provider for reimbursement. 

Currently, we are able to directly bill the following insurance companies: 

  • Alberta Blue Cross

  • Beneva

  • BPA

  • Canada Life

  • Canadian Benefits Provider

  • Chambers of Commerce

  • Claim Secure

  • Co-operators

  • Coughlin

  • D.A Townley

  • Desjardins

  • Electrical Workers Benefit Plan

  • Equitable Life

  • FAS - Ellement

  • First Canadian

  • Greenshield

  • GroupHealth

  • GroupSource

  • Industrial Alliance/ ia Financial Group

  • Johnson

  • Johnston Group

  • Manion

  • Manulife

  • Maximum Benefit

  • Medavie Bluecross

  • Nexgen Rx

  • People Corp.

  • RWAM Insurance

  • Simply Benefits

  • Telus AdjudiCare

  • Quikcard

  • SSQ Insurance

  • Sunlife

  • Union Benefits

  • UV Insurance

If you don’t see your insurance provider listed above, please contact us.

We Direct Bill Alberta Health Care

Many of the services we provide are covered by Alberta Health Care. To facilitate this process, it's essential for patients to bring their Alberta Health Care card to every appointment. Additionally, a piece of government-issued photo ID is required to confirm identity. This system ensures that our patients can access the care they need with minimal administrative hassle, allowing for a smoother, more efficient healthcare experience.

In addition to AHC, we also direct bill many other government funded insurance programs including:

Unethical Insurance Practices

At Helio Optometry eye care clinic, we are committed to upholding the highest standards of ethical conduct in all our operations, especially concerning insurance practices. This policy outlines our stance against unethical insurance practices and measures to ensure compliance with legal and ethical guidelines.

Prohibition of Fraudulent Billing:

  • Billing for Others: It is strictly against our policy to bill for services or products under someone else's insurance. All insurance claims must accurately reflect the identity of the person who received the services or products.

  • Non-Prescription Coverage: We do not use prescription eyewear coverage benefits to purchase non-prescription items, such as sunglasses. Insurance benefits are strictly utilized for their intended purpose as per the policyholder's agreement with their insurance provider. Using insurance funds to purchase non-prescription items can result in you losing your insurance coverage and our ability to bill certain insurance providers. 

  • Altering Dates: Altering the 'date of service' or 'date of sale' to meet specific insurance criteria or for any other reason is strictly prohibited. All transactions and services must be accurately dated and recorded when they occur. 

Insurance Compliance with Legal and Ethical Standards:

  • Our clinic operates in full compliance with all applicable laws, regulations, and ethical standards related to optometry practice and insurance billing.

  • We ensure that all staff members are trained and informed about these standards and the importance of adhering to them.

Insurance Billing Auditing and Monitoring:

  • Regular audits and monitoring are conducted to ensure adherence to this policy. Any discrepancies or violations are addressed immediately.

  • We maintain accurate records of all transactions and services to ensure transparency and accountability.

  • Insurance providers also audit claims regularly and have the legal authority to request all invoices that were billed through your insurance provider.  

Reporting and Addressing Insurance Billing Violations:

  • Employees and clients are encouraged to report any suspected violations of this policy without fear of retaliation.

  • All reports are taken seriously and investigated promptly. Appropriate corrective actions will be taken in cases of policy violation.

Insurance Billing Training and Awareness:

  • Ongoing training is provided to all employees regarding ethical insurance practices to prevent inadvertent violations.

  • We promote a culture of integrity and transparency in all business dealings.

How To Contact Us:

For questions or to report any concerns regarding insurance practices, please contact:

  • ross@heliooptometry.ca