The short answer
Direct billing and reimbursement are two ways of handling a claim. Neither one confirms coverage. Before you book, check the exact service, practitioner, remaining benefit, payer rules and documents with your own plan.
Direct billing: the clinic submits a claim
When direct billing is available, a clinic sends a claim to a payer for you. You may still need to pay a balance because your plan can apply a deductible, co-insurance, annual maximum, per-visit limit or practitioner rule. A clinic can offer direct billing without knowing the final payer decision.
Ask the clinic:
- Do you direct bill my specific plan for this appointment type?
- What balance would I pay if the claim is partly declined or my benefit is used?
- What information do you need before the appointment?
Reimbursement: you pay, then claim
With reimbursement, you pay the clinic and submit a claim afterward. The payer may require an itemized receipt, proof of payment, practitioner designation, date of service or a claim form. Check the current insurer instructions before you rely on being reimbursed.
| Compare before booking | Direct billing | Reimbursement |
|---|---|---|
| Who sends the claim? | Usually the clinic | Usually you |
| When might you pay? | Any balance at the appointment | Usually the full clinic charge first |
| Does it guarantee coverage? | No | No |
| What should you keep? | Claim confirmation and receipt | Itemized receipt, proof of payment and claim record |
A practical pre-payment check
“For this exact service and practitioner designation, can you confirm my remaining benefit, any deductible or co-insurance, whether direct billing is available, and what documents you need if I submit a reimbursement claim?”
Do not send personal health information to BCMedicalAccess. Record only administrative answers in the worksheet below.
Frequently asked questions
What is direct billing?
It is a process where a clinic submits a claim to a payer on your behalf. It does not mean the payer will approve or pay the entire appointment.
What is reimbursement?
You generally pay the provider first, then send the required receipt and claim documents to the payer. The payer applies your plan rules when it reviews the claim.
Which option costs less?
Neither process determines the benefit amount. Your out-of-pocket amount depends on eligibility, limits, deductibles, co-insurance, clinic fees and the payer’s decision.
Free resource: Before You Book: Benefits and Coverage Checklist
Keep the service, practitioner, payer answer and documents in one private planning worksheet.
Related next steps
- Read the broader benefits coverage guide
- Check physiotherapy coverage questions
- Check counselling and psychology coverage questions
- Browse published care profiles
- Get a free physiotherapy concierge review
- Get a free counselling concierge review
Official sources checked
- Services covered by MSP — Government of B.C.
- MSP Supplementary Benefits — Government of B.C.
- Health and dental claims — Sun Life
- Group benefits claims — Manulife
Sources checked October 15, 2026. Payer and government rules can change. Confirm the details that apply to you before booking or paying.