Your Questions Deserve Straight Answers

The opposite, actually.

Our average onboarding timeline — from signed agreement to your first live claim submission — is 4.2 business days. That number is a rolling average across the 4,800+ provider locations we've onboarded since 2013, not a best-case marketing figure.

• Phase 1 (Day 1): We configure your practice profile, practitioners, disciplines, and applicable fee guides. This includes mapping your specific service codes to the correct provincial and carrier-specific formats — a step that's critical for achieving our 96.7% first-pass acceptance rate.
• Phase 2 (Days 1–3): We initiate or verify your direct-billing registrations with each target carrier, running in parallel — not sequentially. Our Credentialing Accelerator handles Sun Life, Manulife, Canada Life, Green Shield, Desjardins, Blue Cross, and dozens more simultaneously.
• Phase 3 (Days 2–3): We integrate with your existing PMS (Jane App, Cliniko, OSCAR, Dentrix — we support them all). Pre-built connectors install in 1–2 days; custom integrations take 5–10 days.
• Phase 4 (Days 3–4): Test claims, validation, and a hands-on training session with your billing team. Not a recorded webinar — a live, interactive walkthrough tailored to your specific workflow.

Alicia Beaulieu's Provider Success team personally manages every onboarding — this isn't a self-serve knowledge base situation. You'll have a named contact, a direct phone number, and a shared onboarding tracker so you always know exactly where things stand.

Carrier registration timelines vary by insurer, but our Credentialing Accelerator — one of the ten stages in our claims lifecycle — dramatically compresses the process by running all registrations in parallel rather than sequentially.

Typical individual carrier timelines once we submit your registration:

• Sun Life: 3–5 business days
• Manulife: 3–5 business days
• Canada Life: 5–7 business days
• Green Shield Canada: 2–3 business days
• Desjardins: 3–5 business days
• Blue Cross (all provincial affiliates): 5–10 business days

Because we run these in parallel, the total elapsed time is determined by the slowest carrier, not the sum of all carriers. For a practice targeting five carriers, you're looking at roughly 7 business days for full registration — compared to 4–12 weeks doing it yourself through individual carrier portals, filling out redundant paperwork, and chasing separate confirmation emails.

We handle all the forms, all the follow-up, and all the credential verification on your behalf. Your staff's involvement is limited to providing a few key pieces of information on Day 1.

No — and we'd actively discourage it.

We integrate with your existing PMS, not replace it. Your front-desk team keeps working in the system they already know. Pre-built connectors exist for Jane App, Cliniko, OSCAR EMR, Juno EMR, Dentrix, ABELDent, Tracker, Universal Office, and others.

If yours isn't on the list, Marc-Olivier Dufresne's Integration Engineering team builds custom connectors. They've completed 47+ to date — each one hand-engineered, individually tested against your specific PMS version and configuration, and maintained ongoing. Marc-Olivier treats every connector like a vintage engine rebuild: precision first, shortcuts never.

Connection methods include REST/JSON API for real-time bi-directional data exchange and encrypted SFTP for file-based batch exchange. Average integration timeline: 1–2 days for pre-built connectors, 5–10 days for custom builds. Either way, the goal is the same: encounter data flows seamlessly from your PMS into the claims platform without double-entry, copy-paste, or manual CSV exports.

The platform serves regulated healthcare providers across every discipline that bills insurance carriers or provincial health ministries in Canada. Our 4,800+ active provider locations span:

• Allied health: Physiotherapy, chiropractic, massage therapy, occupational therapy, speech-language pathology, naturopathic medicine, acupuncture
• Dental: General dentistry, orthodontics, periodontics, oral surgery, dental hygiene practices
• Vision: Optometry, ophthalmology
• Mental health: Psychology, clinical counselling, social work
• Multi-disciplinary clinics: Clinics with three or more disciplines under one roof — these are actually where the platform delivers the most value, because COB routing and multi-carrier billing complexity multiply with each added discipline

Whether you're a solo practitioner with 60 patient encounters a month or a 40-provider multi-location network, the three plan tiers (Solo, Clinic, Network) are designed to scale with your practice. If you're unsure which tier fits, book a 20-minute call and we'll map it out together.

There isn't one. (We know — suspicious, right?)

The prices listed on our Services page are the prices you pay: Solo at $149/month, Clinic at $379/month, Network at custom pricing. No setup fees, no per-claim surcharges, no hidden carrier pass-through costs, no annual escalation clauses, no "platform maintenance" add-ons that appear on invoice three.

The only variable: if you exceed your plan's monthly claims volume, we'll reach out to discuss a plan upgrade — not surprise you with overage charges. We believe the conversation should happen before the invoice, not after.

We've held this pricing philosophy since 2013 because it aligns with our retention strategy: we'd rather earn your business every month through transparent value than trap you with opaque billing. Our 94.3% annual retention rate suggests this approach works.

Monthly billing, no annual contracts, no cancellation fees, no 30-day notice requirements.

You can cancel from your account dashboard in approximately 14 seconds. (We timed it.) There's no retention gauntlet — no "talk to a specialist" phone call, no guilt-trip email sequence, no "are you really sure?" modal that appears five times. Click cancel, confirm, done.

When you cancel, your data remains accessible in read-only mode for 90 days so you can export everything you need — remittance reports, claim histories, analytics. After 90 days, all data is securely purged in accordance with our privacy policy and PIPEDA retention guidelines.

We retain clients because the platform delivers measurable ROI — not because of contractual entrapment. Our annual retention rate is 94.3%, which we consider the only metric that matters.

One claim equals one submission to one carrier for one patient encounter. Clear, predictable, no gotchas.

A split-billing encounter that generates claims to two carriers (primary and secondary) counts as two claims. This is transparently reflected in your dashboard's real-time claims counter.

What does not count against your monthly allowance:

• Validation attempts that are flagged and corrected before submission
• Claims saved as drafts but not yet submitted
• Eligibility verification checks
• Re-submissions of previously rejected claims (correcting and re-sending a rejected claim does not double-count)

So no, fixing a typo four times before submitting doesn't cost you four claims. And if a carrier rejects a claim due to their own processing error, correcting and re-submitting doesn't penalize your allowance either.

No — and this is deliberate.

We deliberately chose monthly-only billing with no annual commitment option. Annual discounts create lock-in, and lock-in reduces our incentive to keep earning your business every single month. It's a structural decision, not a pricing oversight.

We'd rather maintain a 94.3% annual retention rate by being indispensable than by being contractually inescapable. Every month, you choose to stay because the platform is delivering value — not because you pre-paid in January and feel obligated through December.

As our founder Thierry Girard-Beaulieu puts it: "If we can't earn your business this month, we don't deserve your money this month."

This varies by practice size, discipline mix, and current claims workflow — but here's what our data shows across 4,800+ active provider locations:

• Administrative time savings: Average reduction of 11.2 hours per week in billing-related administrative tasks for a mid-sized clinic (5–10 practitioners)
• First-pass acceptance rate: 96.7% platform average vs. 72–78% industry average for manual submissions — meaning fewer rejections, fewer re-submissions, and faster reimbursement
• Average days to reimbursement: 6.3 business days vs. industry average of 14–21 business days for manual claim workflows
• Revenue recovery: Our Denial Management & Appeal Automation stage recovers an average of $2,400/month per practice from claims that would otherwise go unpaid

For a Solo plan at $149/month, most practices achieve full payback within the first 8–12 submitted claims based on time savings alone — before accounting for reduced denials and faster reimbursement. For the Clinic plan at $379/month, payback typically occurs within the first week of active use.

These are estimates based on historical platform data; actual results vary. See our contact page to request a custom ROI projection for your specific practice.

When a patient has coverage under two or more benefit plans — say, their own employer group plan as primary and a spouse's plan as secondary — the platform applies CLHIA (Canadian Life and Health Insurance Association) coordination rules automatically. This is part of our COB & Split-Billing Automation stage.

Step 1 — Priority determination: The system identifies the correct billing priority using the birthday rule for dependent children and employment-based priority for adults. These rules are codified from CLHIA Guideline G6 and updated whenever the guideline is revised.

Step 2 — Primary adjudication capture: It calculates each payer's share based on the primary carrier's adjudication response — the Explanation of Benefits from the primary insurer is automatically parsed and attached to the secondary claim. No manual data entry, no re-keying allowed amounts.

Step 3 — Simultaneous routing: Correctly formatted claims are generated and routed to each payer. The secondary claim includes all required reference data from the primary adjudication, which is the single most common reason secondary claims get rejected when handled manually.

Before this automation, our data shows that multi-payer encounters consumed 15–20 minutes of manual calculation per claim. The COB engine reduces that to zero manual minutes and eliminates the billing overlap errors that trigger carrier audits. For a practice that processes even 30 COB claims per month, that's 7.5–10 hours of administrative time recovered every single month.

Yes — and this is one of the areas where the platform's routing intelligence becomes particularly valuable.

When a patient's provincial health coverage originates from a different province than the provider's location — for example, a BC-covered patient visiting a Calgary physiotherapy clinic — the platform applies the correct interprovincial billing agreement rules, formats the claim to the patient's home province fee schedule, and routes it to the appropriate provincial health ministry.

Reciprocal billing agreements between provinces have specific rules about eligible services, fee schedule application (host province vs. home province rates), and prior authorization requirements. Some services that are covered in the patient's home province may not be eligible for interprovincial billing, and vice versa. The platform manages all of this transparently — the provider simply submits the encounter and the system handles the jurisdictional complexity.

Coverage: All 10 provinces and 3 territories are fully supported for interprovincial routing. This includes the nuanced cases — like Quebec's partial participation in interprovincial agreements, which requires specific handling that trips up most manual billing workflows.

If you operate near a provincial border or in a tourist-heavy region, this feature alone can save your billing team hours of research and phone calls per week. Learn more about how this fits into our broader 10-stage claims lifecycle.

This is — candidly — one of the most under-appreciated risks in Canadian provider billing, and one of the core reasons practices rely on our Fee Guide & Rate Engine Management stage.

Provincial fee guides don't change on a neat annual schedule. Alberta Health, for instance, updated the physiotherapy fee schedule in September 2024 mid-fiscal-year. Providers using manual processes or platforms with slow update cycles under-billed for weeks before catching the change — effectively leaving money on the table for every single patient encounter during the gap.

Our process is designed to eliminate that gap entirely:

• Monitoring: Our fee guide management team monitors all 14 provincial and territorial health ministries and regulatory colleges for published updates — daily, not monthly.
• Validation: Within 48–72 hours of official publication, updated rates are validated by Dr. Sarah Olawale's clinical team and deployed to the platform. Clinical validation ensures the code mapping is correct, not just the dollar amounts.
• Retroactive correction: For retroactive changes, the platform generates a re-submission batch at corrected rates for any claims affected during the gap period. You don't need to identify which claims were affected — the system does that automatically.

Covered disciplines: physio, chiro, dental, optometric, psychology, OT, SLP, massage, naturopathic, and other regulated disciplines across all provinces and territories.

The platform supports the following electronic data interchange formats, covering every major standard used by Canadian insurance carriers and provincial health ministries:

• EDI 837P — Professional claims (medical, allied health). This is the dominant standard for physiotherapy, chiropractic, psychology, and other allied health submissions.
• EDI 837D — Dental claims, used by carriers that accept ANSI X12 dental formats.
• EDI 835 — Electronic remittance advice. Carrier payment responses are automatically parsed and matched to original claims in your dashboard.
• CDAnet — Transaction encoding for dental claims per the Canadian Dental Association standard. Required by most Canadian dental carriers.
• HL7 FHIR — For provincial health ministry integrations that have adopted the newer FHIR standard.
• Proprietary API formats — For carriers that don't support standard EDI (more common than you'd expect — several mid-size carriers still use proprietary submission formats).

All formatting and translation happens transparently — providers submit in a single standardized format and the platform handles carrier-specific encoding on the back end. You never need to think about whether Sun Life expects an 837P while your dental carrier expects CDAnet. (That's our problem, and we prefer it that way.)

For technical details on how this fits into the broader claims routing architecture, see Stage 5: Carrier Routing & EDI Translation on our Services page.

Yes — pre-built integrations exist for Jane App, Cliniko, OSCAR EMR, Juno EMR, Dentrix, ABELDent, Tracker, Universal Office, and several others. These connectors are maintained and updated whenever the PMS vendor releases API changes, so you're never caught with a broken connection after a software update.

Connection methods:

• REST/JSON API: Real-time bi-directional data exchange. Patient demographics, encounter data, and billing codes flow from your PMS into the claims platform; adjudication results and remittance data flow back. No double-entry.
• Encrypted SFTP: File-based batch exchange for PMS systems that don't support real-time API access. Automated on a schedule you configure — hourly, end-of-day, or on-demand.

If your PMS isn't on the list, Marc-Olivier Dufresne's Integration Engineering team builds custom connectors — they've completed 47+ to date. Each integration is a precision engineering project: no shortcuts, no generic middleware templates, fully tested with your specific PMS version and configuration before go-live.

Average integration timeline: 1–2 days for pre-built connectors, 5–10 days for custom builds. Either way, your staff won't need to learn a new system — the claims platform operates as a seamless extension of the tools they already use.

Yes — real-time eligibility verification is built into the Pre-Submission Validation stage of our claims lifecycle.

Before a claim is submitted, the platform queries the carrier to confirm:

• Whether the patient's policy is active as of the date of service
• Whether the specific service code is covered under their benefit plan
• Remaining annual maximums and per-visit limits
• Whether prior authorization is required
• Applicable deductible status

This check happens in seconds and catches the most common reason claims get rejected: submitting for a patient whose coverage has lapsed, whose benefit year has reset, or whose plan doesn't cover the specific service. Finding this out before the patient leaves your office — rather than two weeks later when the claim comes back denied — is the difference between getting paid and having an awkward phone conversation.

Eligibility checks do not count against your monthly claims allowance.

Every layer of the platform is designed with privacy as an architectural decision — not a compliance afterthought. This is overseen by Jordan Flett, CISA, our Chief Information Security Officer, who runs quarterly privacy impact assessments and coordinates annual third-party penetration testing.

• Encryption in transit: TLS 1.3 for all data transmission — the current highest standard. No fallback to older protocols.
• Encryption at rest: AES-256 for all stored data, with hardware security modules (HSMs) managing encryption keys
• Infrastructure: Hosted exclusively in SOC 2 Type II-certified Canadian data centres (Calgary and Toronto) — no data ever leaves Canadian soil
• Certification: SOC 2 Type II attestation audited annually by Deloitte Canada (most recent: March 2026)
• Regulatory compliance: PIPEDA (federal), HIA (Alberta), PHIPA (Ontario), PIPA (BC), PHIPAA (New Brunswick), and all other applicable provincial privacy legislation
• Access controls: Role-based access control (RBAC) with mandatory multi-factor authentication for all provider accounts. Audit logs track every data access event.
• Internal controls: Quarterly privacy impact assessments, annual third-party penetration testing, and mandatory security awareness training for all staff

Our 13-year operating history (2013–2026) includes zero reportable privacy incidents. For full details on how we handle your data, see our Privacy Policy.

Exclusively in SOC 2 Type II-certified Canadian data centres located in Calgary and Toronto.

No data ever leaves Canadian soil. No US cloud regions, no "data may be transferred" clauses, no exceptions. This applies to all data types — patient health information, provider credentials, billing records, analytics, backups, disaster recovery replicas. Everything stays in Canada, full stop.

This has been a foundational architectural decision since 2013 and it has never been reconsidered — not once, not for any carrier integration requirement, not for any cost optimization. (Some decisions are too important to revisit, even when AWS offers a really compelling US-East pricing tier.)

Canadian data sovereignty isn't a marketing badge for us — it's a contractual commitment documented in our Terms of Service and Privacy Policy. If this matters to your practice — and it should — we're happy to provide written confirmation for your compliance records.

Our breach response protocol — documented, rehearsed quarterly through tabletop exercises, and fully auditable — includes:

• Immediate containment: Isolation of affected systems within minutes of detection, not hours. Automated threat containment systems supplement human response.
• Provider notification: Affected providers are notified within 24 hours with a clear, jargon-free explanation of what happened, what data was affected, and what steps we're taking.
• Regulatory notification: The Office of the Privacy Commissioner of Canada and applicable provincial privacy commissioners are notified as required under PIPEDA and provincial legislation.
• Forensic investigation: Full forensic investigation with findings published to affected parties — no vague "we take security seriously" statements, but actual technical details and remediation timelines.
• Remediation and prevention: Root cause analysis and implementation of additional controls to prevent recurrence, with follow-up reporting to all affected parties.

We carry $10 million in cyber liability insurance underwritten by a Canadian insurer.

In our 13-year operating history (2013–2026), we have had zero reportable privacy incidents. We share this stat not out of complacency — but because it demonstrates that the controls work. The quarterly rehearsals ensure we're prepared even though we've never had to execute the protocol for real.

We maintain compliance with every applicable federal and provincial privacy regulation governing health information in Canada:

• PIPEDA — Personal Information Protection and Electronic Documents Act (federal)
• HIA — Health Information Act (Alberta)
• PHIPA — Personal Health Information Protection Act (Ontario)
• PIPA — Personal Information Protection Act (British Columbia)
• PHIPAA — Personal Health Information Privacy and Access Act (New Brunswick)
• PHIA — Personal Health Information Act (Manitoba, Newfoundland & Labrador)
• HIPA — Health Information Protection Act (Saskatchewan)

Compliance isn't a one-time checkbox — it's an ongoing operational commitment. Jordan Flett, CISA, serves as our designated PIPEDA Compliance Officer and can be reached at compliance@providerclmconnect.com for any privacy-related inquiries. Our SOC 2 Type II attestation is audited annually by Deloitte Canada, with the most recent audit completed March 2026.

If your practice requires a signed Business Associate Agreement, Data Processing Agreement, or privacy impact assessment documentation for your own compliance records, we provide these upon request — typically within 2 business days.

WCB claim workflows differ materially between provinces — different intake forms, injury coding requirements, progress reporting intervals, fee schedules, and authorization workflows. What works for WCB Alberta will get rejected by WorkSafeBC, and vice versa. This is part of our WCB & Specialty Claims Processing stage.

Our platform applies geo-aware routing logic: based on the clinic's location and the applicable WCB jurisdiction, it automatically selects the correct form set, fee schedule, reporting template, and submission channel.

Supported jurisdictions:

• WCB Alberta
• WorkSafeBC
• WSIB Ontario
• WCB Saskatchewan
• WCB Manitoba
• WorkplaceNL (Newfoundland & Labrador)
• WCB Nova Scotia
• WorkSafe New Brunswick
• WCB Prince Edward Island

Each WCB module includes employer data capture, injury mechanism coding (aligned with the jurisdiction's specific taxonomy), file number tracking, Section B form generation, treatment plan approvals, and progress reporting — all the elements that make WCB claims consume 3–4× the administrative time of standard carrier claims when handled manually.

The platform also tracks treatment authorization limits and alerts you when you're approaching the authorized visit cap — so you never deliver treatment that won't be reimbursed because an authorization expired without anyone noticing.

Yes — and MVA claims are precisely the type of high-complexity, high-frustration workflow where the platform delivers outsized value.

MVA claims involve insurer-specific Section B forms (particularly in Alberta and Ontario), treatment plan approvals, authorized treatment caps, distinct billing formats that differ from standard private carrier submissions, and ongoing communication with auto insurers who have their own adjudication timelines and documentation requirements.

The platform manages the full MVA claims lifecycle:

• Initial intake and auto-insurer identification
• Section B form generation with pre-populated patient and provider data
• Treatment plan submission and authorization tracking
• Authorized treatment cap monitoring with proactive alerts
• Progress reporting on the insurer's required schedule
• Final settlement billing and reconciliation

Before the platform, our data shows that MVA claims consumed an average of 35 minutes of administrative time per encounter. After: under 5 minutes. For a practice that handles 20 MVA patients per week, that's roughly 10 hours of administrative time recovered — every single week.

If MVA claims are a significant part of your practice, book a call and we'll walk you through the MVA-specific workflow in detail.

Denials are inevitable — even with a 96.7% first-pass acceptance rate, some claims will be rejected due to carrier adjudication decisions, benefit plan limitations, or documentation requirements. What matters is how quickly and effectively those denials are resolved.

Our Denial Management & Appeal Automation stage handles this systematically:

• Automatic denial categorization: Each rejected claim is classified by denial reason code — insufficient documentation, coding mismatch, authorization missing, eligibility lapsed, etc.
• Auto-correctable denials: For denials caused by coding errors, missing modifiers, or format issues, the platform generates a corrected re-submission automatically. No manual intervention required.
• Appeal generation: For denials requiring a formal appeal, the system generates a pre-populated appeal letter with the correct carrier-specific format, supporting documentation references, and applicable regulatory citations.
• Tracking and escalation: Every denial and appeal is tracked through resolution, with automated follow-up if the carrier doesn't respond within their stated adjudication timeline.

On average, our denial management process recovers $2,400/month per practice from claims that would otherwise go unpaid. Re-submissions of denied claims do not count against your monthly claims allowance.

Every account — from the $149/month Solo plan to enterprise Network contracts — receives the same level of human support. There's no tiered support where paying more gets you faster responses. That model penalizes smaller practices, and we're not interested in it.

• Phone support: Direct line to Alicia Beaulieu's Provider Success team during business hours (Monday–Friday, 8 AM–6 PM MT). No IVR maze, no "your call is important to us" hold music loop. A human answers.
• Email support: Guaranteed response within 4 hours during business hours. Average actual response time: 47 minutes.
• Emergency support: For platform outages or critical billing issues, an after-hours emergency line is available 24/7.
• Onboarding support: Your named onboarding contact stays with you for 90 days post-go-live, not just through the initial setup.

We don't use chatbots. We don't route you to an offshore call centre. We don't ask you to "check our help documentation first." If you have a question, you talk to someone who understands Canadian healthcare billing — because that's literally all we do.

Have a question right now? Reach out anytime or call us directly at (702) 343-8317.

Absolutely — and not with a generic webinar recording.

Every new practice receives a live, interactive training session tailored to their specific workflow, PMS integration, discipline mix, and carrier profile. Training is conducted by a member of the Provider Success team who understands your specific configuration — not a general-purpose trainer reading from a script.

What training includes:

• Hands-on walkthrough using your actual practice data (test claims, not hypothetical examples)
• PMS integration demonstration — showing exactly how data flows between your existing software and the claims platform
• COB and split-billing workflow training (if applicable to your practice)
• Dashboard navigation, reporting, and analytics overview
• Common troubleshooting scenarios specific to your carrier mix

Additional training sessions for new staff members are available anytime at no extra cost. We'd rather spend 45 minutes training a new hire properly than field avoidable support calls for six months.

Easier than you'd expect. We've migrated practices from TELUS Health eClaims, ClearConnect, HEALTHclaim, and various carrier-specific portals — and the process follows the same 4.2-day average onboarding timeline as a fresh setup.

What we handle during migration:

• Transfer of your existing carrier registrations (you don't need to re-register with each carrier from scratch)
• Historical claims data import, so your reporting continuity isn't broken
• PMS integration reconfiguration to point to our platform instead of your previous provider
• Parallel running period — we can operate alongside your existing platform for a transition period to ensure nothing falls through the cracks

The goal is zero disruption to your billing operations. Your front desk submits claims on a Monday through the old system and on Tuesday through ours — with the same PMS, the same workflow, and the same patient experience. The only difference is what happens after they click "submit."

Ready to discuss a migration plan? Book a 20-minute call and we'll map out the specifics for your practice.