Direct Billing for Therapy Services in Ontario

Insurance plans often provide coverage for specific professional designations, so we encourage you to review your individual plan details prior to beginning services.

MHN clinicians may hold the following professional designations:

* Registered Social Worker (RSW)
* Master of Social Work (MSW)
* Canadian Certified Counsellor (CCC)
* Registered Psychotherapist (RP)

** Please note: MHN does not currently offer Psychologist services.

Most insurance plans include a maximum yearly coverage amount for therapy services. 

Many clients find it helpful to review their coverage details ahead of time and consider a therapy schedule that feels supportive, sustainable, and aligned with their needs.

Some insurance plans may cover a percentage of each therapy session, while others may include a set maximum amount per visit. 

Depending on your coverage, a remaining balance or co-payment may apply after your claim has been submitted.

Benefit renewal dates vary between insurance providers and plans. 

Many plans reset annually, while others may renew based on your employer’s benefit cycle. We encourage you to review your individual plan details to better understand your coverage timelines and available benefits.

If your insurance coverage reaches its limit or becomes inactive, future sessions may continue as private pay services through credit card or e-transfer payment. Once your benefits reset or become active again, simply let our team know and we will gladly resume eligible direct billing submissions when available.

Direct billing availability varies between insurance providers and individual benefit plans. 

We encourage you to confirm your coverage details directly with your insurance provider, including eligible professional designations, reimbursement amounts, limitations, and direct billing eligibility.

Please note that MHN is unable to verify in advance whether a claim will be accepted. 

If a claim is declined, rejected, or not fully covered, any remaining balance will become your responsibility.

The insurance providers listed below are those that currently allow eligible direct billing submissions through MHN, subject to their individual terms and conditions.

If your extended health benefits provider is not listed, you may still have coverage for therapy services. 

In these situations, payment would be made privately and a receipt will be provided for you to submit directly to your insurance provider for reimbursement.

When multiple insurance plans are available, insurance providers determine which plan is considered your primary coverage. 

When eligible direct billing is permitted, MHN is able to submit claims to one primary insurance provider only.

At this time, MHN does not coordinate benefits or submit claims to secondary insurance plans. 

If a session is not covered in full, any remaining balance may be charged to the credit card on file unless alternative arrangements have been discussed in advance.

Primary insurance coverage is generally determined as follows:

• For adults, the primary plan is typically your own insurance plan
• If both you and your partner have coverage, claims can only be submitted to your personal plan
• For children covered under two parents, the primary plan is usually determined by the parent whose birthday occurs first in the calendar year (month and day)

You may still be able to independently submit remaining balances to a secondary insurance provider for possible reimbursement.

Most insurance providers allow claims to be submitted manually online, through a mobile app, or by mail. 

Your insurance provider can help you understand how claims are submitted, current processing times, and whether reimbursement is issued by direct deposit or mailed cheque.

After payment for your appointment has been processed, you will receive a receipt that includes your therapist’s professional designation and registration number, which are commonly required for insurance claim submission.

You are responsible for confirming your extended health benefits coverage details and ensuring the information provided to Maternal Health Niagara remains accurate and up to date, including any changes to your insurance plan or policy information.

Existing clients are welcome to request a transition to eligible direct billing at any time, in accordance with MHN’s terms and conditions.

To get started, please contact our Client Care Team at support@maternalniagara.ca.

Direct billing can begin once all required insurance information and documentation has been received, reviewed, and approved.