A clinician in a white coat talking a patient through his CPAP machine, with the patient record on the screen beside them.

For vendors and clinic administrators

Funding programmes and payer billing.

Q: How does a clinic split one invoice between a funding programme, an insurer and the patient?

Raise one invoice at the full price, then add each payer to it with its own coverage rule: a percentage of a named approved price, a percentage of the invoice total, or a fixed amount, applied to the whole invoice or to single lines. norvelle works out each payer's share, and the patient's portion is the remainder. The shares together can never exceed the invoice total, each share can be billed to that payer as its own numbered invoice so payer debt ages separately, and payment taken from the patient is taken against their portion only.

Q: Does norvelle send the claim to the programme?

No. norvelle records the split, the approval number and the money, and prints what a payer needs. Submitting the claim stays with your team, in whatever way that programme or insurer accepts.

Q: Where does the approval number live?

On the payer's share of the invoice. A payer can be set to require an approval or claim reference, so a share that needs a number cannot quietly go out without one.

Q: What happens when a payer refuses its share?

Your team appeals it, writes it off, or bills the patient for it. An appeal that goes 60 days without an answer returns the amount to the patient, so nothing sits in a drawer unowned.

Q: One cheque covers thirty patients. Does that have to be split by hand?

No. Apply one programme or insurer payment across many invoices in a single pass, with its remittance number recorded, and reverse the whole remittance if it does not clear.

Q: Can every clinic in a group have different payers?

Yes. The payer directory belongs to the brand, and each payer can be shown or hidden per clinic, so a location only sees the payers it bills.

One invoice at the full price, split across the funding programme, the private insurer and the patient, with every share tracked to the day it is paid.

Book a demo See the split

A coverage rule per payer Approval numbers per share Payer debt ages on its own

One invoice, many payers

The programme, the insurer and the patient, on one invoice.

Raise the invoice at your price. Add each payer with its own coverage rule. What is left is the patient's.

A percentage of a named base

Set the rule once on the payer, and every invoice that carries that payer applies it.

A percentage of a named approved price, the way a funding programme works.
Or a percentage of the invoice total, the way most private plans work.
Per whole invoice, or per line, when a programme funds the machine and not the accessories.

A fixed amount

For a payer that pays a set figure regardless of what the item costs.

The shares on one invoice can never add up to more than the invoice total.
Adding a payer never changes the total: it moves who owes it.
The patient's remainder is worked out, never typed in.

Sample

A funding programme at 75% of an approved price

A funding programme at 75% of an approved price
Item	Amount
Positive airway pressure system, approved price	$554.00
Invoice total	$554.00
Funding programme 75% of the approved price	-$415.50
Patient owed	$138.50

Sample figures, not a real patient. The programme share is a percentage of the price the programme approves, not of whatever the clinic charges.

Sample figures, not a real patient. Invoice lines carry no tax unless the catalogue item is taxable, and respiratory supplies are set up zero rated.

After the split

From coverage rule to money in the bank.

Five steps, each one a screen your billing team already works in.

1

Record the approval number

A payer can be set to require an approval or claim reference, and the number is captured on that payer's share, not buried in a note.

2

Bill the payer separately

The payer's share becomes its own numbered invoice addressed to the programme or insurer, so payer debt ages apart from the patient's.

3

Chase the patient for the remainder only

Aging and the collections worklist work off the patient's share. Nobody calls a patient about money a programme still owes.

4

Apply one payment across many invoices

A programme or insurer pays for twenty patients at once. Enter the remittance number, apply it across the invoices, and reverse the whole remittance if it does not clear.

5

Deny, appeal, or return it to the patient

When a payer refuses its share, your team appeals it, writes it off, or moves it to the patient. An appeal left unanswered for 60 days goes back to the patient by itself.

What the administrator sees

Payer debt, counted as its own thing.

Outstanding by payer

What each programme and insurer still owes you, on screen or as a spreadsheet.

Two balances, never mixed

Every invoice shows the patient's balance beside the amount still sitting with a payer.

The payer copy of the invoice

Print a copy for a payer already on the invoice, listing its portion and the rule that produced it.

A directory you control

Programmes and insurers live in a payer directory per brand, each with its own coverage rule and its own visibility per clinic.

Shares that cannot overrun

The payer shares on one invoice can never add up to more than the invoice total.

Your people do the deciding

A person adds the payer and picks the rule. norvelle does the arithmetic and keeps the record.

The programmes

Who funds respiratory equipment in Canada.

What each programme publishes about how a vendor is paid. Every entry is sourced and dated at the foot of this page.

Assistive Devices Program (ADP), Ontario

Ontario pays 75% of the Assistive Devices Program approved price for respiratory equipment, paid directly to the business that sold the equipment, and the client pays the other 25% to that business. For clients receiving Ontario Works, the Ontario Disability Support Program or Assistance for Children with Severe Disabilities, the programme pays 100% of the approved price.

Assistive Devices Program (ADP) billing for CPAP clinics

Home oxygen, province by province

Home oxygen is funded one province at a time: Ontario through the Assistive Devices Program, British Columbia through health authority home oxygen programmes, Québec through the Programme national d'oxygénothérapie à domicile. Each province names who assesses the client and which business may supply the equipment.

Home oxygen funding across Canada

Non-Insured Health Benefits (NIHB)

The federal benefits list for First Nations and Inuit clients requires prior approval for every respiratory equipment and supplies benefit, and names which prescribers and which enrolled providers may supply each item. Items carry an 8 digit item code used for billing.

Non-Insured Health Benefits (NIHB) billing

Workplace Safety and Insurance Board (WSIB), Ontario

Where a work-related injury or disease is the reason for the equipment, the WSIB may authorize the purchase, expects the worker to buy from a supplier that has an agreement with the WSIB, and pays that supplier directly. Approval is sought before the purchase.

WSIB billing for respiratory equipment

Ontario Works and the Ontario Disability Support Program

Both programmes cover the consumer contribution for a device funded by the Assistive Devices Program. The share the client would otherwise pay is settled between the ministries rather than collected at the counter, and the vendor may be asked to confirm that the client receives social assistance.

ODSP and Ontario Works on a funded invoice

Veterans Affairs Canada and the Interim Federal Health Program

Veterans Affairs Canada pays for oxygen therapy and respiratory equipment under Program of Choice 9, at the rate it has established, as full payment. The Interim Federal Health Program pays 70% of eligible costs for medical supplies and equipment, and only to providers registered with it. Medavie Blue Cross administers both.

Veterans Affairs Canada and IFHP billing

Questions administrators ask.

How does a clinic split one invoice between a funding programme, an insurer and the patient?

Does norvelle send the claim to the programme?

Where does the approval number live?

What happens when a payer refuses its share?

One cheque covers thirty patients. Does that have to be split by hand?

Can every clinic in a group have different payers?

Sources

Captured 2026-10-16. Every programme described on this page is described from its own published page, read on that date. Programme rules change: check the source before you rely on it.

Assistive Devices Program, respiratory equipment and supplies, 75% of the approved price, the client's 25%, and 100% for recipients of Ontario Works, the Ontario Disability Support Program or Assistance for Children with Severe Disabilities: ontario.ca/page/respiratory-equipment-and-supplies (page updated 2026-02-18).
The funding models, including the fixed price model and the rule that a vendor cannot charge the client more than the approved price: Policies and Procedures Manual for the Assistive Devices Program, policy 305, files.ontario.ca/moh-adp-policies-and-procedures-manual-assistive-devices-program-2023-07-01.pdf (July 2023).
Non-Insured Health Benefits, prior approval required for all respiratory equipment and supplies, recognized prescribers and enrolled providers, and the 8 digit item code: Indigenous Services Canada, 8.0 Respiratory equipment and supplies benefits list, sac-isc.gc.ca/eng/1585323161648 (effective 2026-07-29).
WSIB authorization of health care equipment and supplies, purchase from a supplier with a WSIB agreement, payment made to that supplier, and approval before purchase: WSIB Operational Policy Manual 17-07-06, wsib.ca/en/operational-policy-manual/health-care-equipment-and-supplies (published 2024-12-05).
Ontario Disability Support Program coverage of the consumer contribution for an Assistive Devices Program device: ontario.ca/document/ontario-disability-support-program-policy-directives-income-support/96-assistive-devices (directive 9.6, updated 2026-03-10).
Ontario Works coverage of the remaining share for social assistance recipients: ontario.ca/document/ontario-works-policy-directives/78-assistive-devices (directive 7.8, updated 2026-04-14).
Home oxygen, read 2026-10-18: Ontario, 75% of the cost with the client paying 25% and 100% coverage for several named groups, ontario.ca/page/home-oxygen-therapy (page updated 2025-07-10); British Columbia, assessment and funding by the health authority with supply through an approved oxygen supplier, healthlinkbc.ca/find-care/find-health-services/program/home-oxygen-program; Québec, the loan of equipment with no fee and no deductible under the Programme national d'oxygénothérapie à domicile, quebec.ca/sante/systeme-et-services-de-sante/aides-techniques-deficiences-et-handicaps/programme-national-oxygenotherapie-a-domicile-pnod (page updated 2023-05-09).
Veterans Affairs Canada, oxygen therapy and respiratory equipment under Program of Choice 9 and payment at the established rate as full payment, veterans.gc.ca/en/about-vac/reports-policies-and-legislation/policies/oxygen-therapy-and-respiratory-equipment-poc-9 (effective 2025-03-31). The Interim Federal Health Program, 70% of eligible costs for supplemental benefits including medical supplies and equipment, coverage only from registered providers, and administration by Medavie Blue Cross: canada.ca/en/immigration-refugees-citizenship/services/refugees/help-within-canada/health-care/interim-federal-health-program/coverage-summary.html (read 2026-10-18).

See a funded invoice built.

Watch one invoice split across a programme, an insurer and the patient on a working clinic with synthetic patients.

Book a demo See Assistive Devices Program billing