Our dog was terribly ill and being able to go ahead with all the tests the vets were suggesting, knowing that Trupanion would cover the costs was such a relief. Having direct billing made it even easier at the end of the visit as we were only responsible for paying the difference rather than the whole cost up front and waiting for a refund. It took about 15 mins for our claim to go through. Amazing! We are happy to say that because of our coverage, we could afford all the treatments necessary and our dog is now on her way to feeling better.