Direct Billing with Blue Cross

How Revolution direct bills to blue cross

  • Assessments and first sessions with Revolution are always paid for out of pocket in the clinic.

  • Upon request for direct billing to Blue Cross, your therapist will send you the Blue Cross intake form.

    • This form gathers all the information and permissions we need to direct bill on your behalf.

    • For your reference, the consents required for direct billing are listed below.

Permission to Direct Bill: I authorize the service provider (Revolution Rehab Inc.) to submit claims to Manitoba Blue Cross on my behalf.

Privacy and Sharing of Information: I authorize the clinic and its associated health professionals to collect my personal and Blue Cross Member information as documented above. In addition, I authorize the clinic and its associated health professionals to communicate with the insurer as deemed necessary. I also understand that my personal and medical information is confidential and will only be disclosed to third parties with my permission.

Understanding of Coverage Limits: In the case that my policy does not cover 100% of the treatment, I agree to pay the remaining balance to the service provider (Revolution Rehab Inc.) within 48 hours of notification.

Prescription: In the event that a prescription is required, I understand that it is my responsibility to submit the prescription to the insurance provider before direct billing can be implemented.