Massage Therapy Niagara
905-357-7686
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Direct Billing Policy

We offer direct billing to insurance as a courtesy for our clients. This is not a mandatory service. Please understand it is beyond our control if your insurance policy does not allow direct billing, will not pay us directly (will only pay the insured member) or will not pay the claim for some reason. If there are any reasons why the claim cannot submit successfully, please contact your insurance company. If we cannot direct bill to insurance, we will issue you a receipt for payment and you may submit your claim yourself. Please have a method of payment available should your claim be unsuccessful.

Direct Billing Consent, Authorization and Acknowledgement

Direct Billing Consent, Authorization and Acknowledgement form

Direct Billing Consent, Authorization and Acknowledgement form

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