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CREDIT CARD INFO FOR
OUTPATIENT SERVICES
THIS SECTION TAKES ABOUT 4 MINUTES TO READ & COMPLETE
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IMPORTANT INFORMATION ON THE
PATIENT HEALTH INSURANCE BILLING PROCESS
YOUR INSURANCE: At the end of each month, your credit card will be processed to pay for the month's treatments.

We will then immediately send you a professional receipt for your insurance submission.

Once submitted, insurers usually take 48 hours to refund client.

A credit card pre-authorized deposit may be required before you begin your treatment for the first month,.
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C R E D I T   C A R D
Credit Cards for clinic services are processed at end of each month. Any consultation, membership or examination fee is processed prior to appointment or use of facility privileges.

Information provided held by BCD Administration Centre in Toronto.
Your card will NOT be processed today.
Credit Card
What type of credit card

Thanks for submitting!

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MY INSURANCE INFO
Optional submission of insurance information for our records. We do NOT bill insurance directly - our experience has shown that insurers are affirmatively not optimally cooperative & user-friendly with clinics.

Direct billing would otherwise add costs to your treatments. When the client contacts the insurer for non-payment their response is significantly more inviting & service-focused.

If you would like the insurance information on your receipts please provide the information as outlined below. It is not a requirement, however, for your insurance submission processes.
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How much $ per year does the insurer cover for 'chiropractic'?

Is there a deductible? (for example, they cover only 80% of the fee)

Thanks for submitting!

Please remember that the insurance information is for the purpose of adding to your receipt for submissions. To keep costs down, we do NOT do direct insurance billing.

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