Insurance Reimbursement
third party billing & client insurance coverage
About third party Insurance Reimbursement for clients
Benefits coverage for your clients is mostly dependent on the benefits plan each client has with their benefits provider. It is most common for an employer to offer a benefits plan to employees as part of their compensation plan. If your client has a benefits plan with a particular third party insurance provider, the first step is that your client should contact the benefits plan administrator, which is often a person in their workplace HR department, who can review the details of the plan with them.
They can also contact representatives of the insurance provider to explain the breadth and depth of their specific plan, as each company offers many plans to many employers across Canada. Some employers choose to cover mental health services and often specify ACCT members as eligible service providers. However, if the plan does not offer mental health benefits or it does not specify ACCT members as desired service providers, then coverage may be denied.
Your client can ask their employer to adjust the benefits plan to allow coverage for services provided by ACCT members. If the purchaser of the plan (employer), requests changes, the insurance provider usually complies. It really depends on the plan that was set up by the employer and the insurance company.
For Registered Therapeutic Counsellor - Candidates (RTCc): your services may not be covered by ACCT agreements with third-party insurance companies or benefits providers. Once you are eligible and have advanced to the RTC designation your services may be covered by the ACCT agreements in place. Please note, that some members have reported that some plans do accomodate the RTCc designation, it just depends on the insurance plan that the employer of your client has negotiated with the insurance agency.
template letters to advocate for clients and employers
We have provided a number of templates and letters from ACCT to help counsellors and their clients advocate for coverage. We hope some of our suggestions below will be helpful to you. Firstly always have your client check their policy to see if their coverage specifies what type of counselling services are covered. Please note, if the insurance company or benefits provider has reimbursed the client for initial sessions and is refusing to provide reimbursement for a subsequent session, clients will often have success by consistently and firmly insisting that coverage continue. However if the client’s policy does cover counsellors or counselling services then the letter templates below could be used to support the client in advocating for coverage for ACCT members.
Download the Sample Letters by clicking below:
acct agreements with third-party insurance companies
To date, the following providers have agreed to reimburse ACCT counsellors for those plans that include counselling services:
Alberta Blue Cross may recognize ACCT counsellors, but they cautioned that only a small number of their policies cover clinical counsellors. Most of their policies specify coverage through a psychologist or social worker and you would not be covered in those cases.
The Alberta School Employee Benefit Plan has added ACCT to their approved association's list, and they will cover the services of counsellors holding ACCT designations of RTC, MTC, RCS.
ClaimSecure has added ACCT to their approved association's list. Please ensure your client's policy covers "counsellors", if the policy states "clinical counsellors" you will not be covered. Claimsecure distinguishes between therapeutic and clinical counsellors.
Equitable Life of Canada is accepting all ACCT designations for those with their registration in good standing.
Green Shield Canada will cover ACCT members for plans that cover clinical counsellors. To be covered, please set up a Health Professional Provider of Service Account by filling out the application.
iA Financial Group (Industrial Alliance Insurance and Financial Services Inc.) has accepted the ACCT as an eligible association.
Manitoba Blue Cross has confirmed that they will cover the services of counsellors holding ACCT designations of RTC, MTC, RCS if it is a counselling plan.
Pacific Blue Cross has agreed to reimburse clients for the services of counsellors holding any ACCT designation (RTC, MTC, RCS) for plans that cover the services of clinical counsellors.
Victor Insurance has added ACCT as an approved provider.
Sun Life has added ACCT to its approved association's list, however for your services to be reimbursed the terms of your client’s policy must state that Counselling or Psychotherapy are covered.
Note: To be added as an approved provider with Sun Life, please follow the steps below.
Call the Sun Life provider line at 1-855-301-4786
The first prompt is for service in English or French: select #1 for English (if you prefer English)
The next prompt is for questions regarding their new eClaims system. Select #3 for being a Health Practitioner.
You will then be routed to the next available representative. (This took 15 minutes).
The representative is located outside of Canada so speak slowly and precisely.
They will ask if you are calling with regards to a Medical or Dental claim. Explain that you are not doing either;
Explain to the Sun Life Agent that you are a "clinical counsellor and psychotherapist and you would like to update your profile or be added to their list of approved providers". The Agent may go on to explain that at this time, the new eClaims portal only serves Paramedics, Dentists and Physiotherapists but they are adding more services all the time.
Explain to the representative that you were told to call this number so that your profile can be added or updated manually.
The Sun Life Agent will need to add you to their list of approved clinical counsellors and psychotherapists manually and will take all your information verbally over the phone including: name on ACCT list, address of practice, ACCT number, phone number. Do not use the acronym A.C.C.T., instead, use the full name: Association of Cooperative Counselling Therapists of Canada.
They will process this application and will take up to ten days. They may phone the number provided to confirm acceptance to their list.
You can ask the representative for their name and a reference # for your call in case you do have to call back.
Some helpful information when calling:
The Sun Life Agent should check for our Association under "Clinical Counselling and Psychotherapy"
Advise that you are with the Association of Cooperative Counselling Therapists rather than our acronym: ACCT.
The Provider Profile Team will check our Registered Member List to confirm you are a member of ACCT. This is a list of members who are in good standing, i.e.; have met all requirements for membership or renewal. Renewal requirements can be found here.
Some agents may ask for your address and telephone number.
If you are unsuccessful the first time, call back and try to speak to a different agent. Members have reported that this worked for them.
Once you have been approved by Sun Life, you can register yourself as a counsellor, for free in their new searchable app, Lumino Health.
CASe by Case third party insurance providers:
Canada Life does not have an official agreement with ACCT, however they appear to review claims on a case by case basis.
ManuLife claims are reviewed on a case by case basis; they do not do a formal review of associations.
If your client's insurance provider is accepting an ACCT Counsellor, please let us know so we can share this information with all ACCT members.
insurance providers who require counsellor with a Master's degree:
ComPsych has added ACCT to their approved association's list. ComPsych contracts with counsellors as service providers; however, they require a master degree.
ICBC - Are you providing clinical counselling treatments to clients who have been injured in a car crash? In order to receive compensation from ICBC, you will need to be a member in good standing with ACCT, and hold a relevant master's degree.
For more information and to apply for a vendor number please go to ICBC Clinical Counsellors
