Telehealth: Claims submission guidelinesWednesday, May 20, 2020
Pacific Blue Cross has been working hard to establish policies and practices that allow eligible providers (including psychology, chiropractic, physiotherapy, and hearing) to claim telehealth services.
There are specific requirements for submitting telehealth claims for reimbursement. They are as follows:
- All college and association guidelines for conducting business virtually or via telehealth should be referenced and followed. All usual regulations that apply to a practitioner and practice should also continue to be followed.
- Charges for "screening” calls or file reviews when determining patient fit for telehealth are not eligible.
- Check-in call charges are not eligible.
- Virtual appointments should be charged at the same cost and duration as in-clinic visits and provide the same level of service, i.e. no additional fees or appointment duration should be billed due to virtual appointment barriers.
- Exercise or group appointments or classes are not eligible.
- Only services within a practitioner’s scope of practice and that are eligible within Pacific Blue Cross contracts will be considered.
Note: Benefits vary from plan to plan. Members should verify benefits coverage for telehealth services prior to appointment.
For additional information, please visit your individual provider section on pac.bluecross.ca/provider
As BC's health benefits society, we want to ensure our members and providers have the tools they need to navigate the most recent developments related to COVID-19 (coronavirus). To stay up to date on the latest information, we recommend that all health providers in British Columbia continue to follow advice from the BC Centre for Disease Control, their Professional College, as well as the government of BC.