UNINSURED SERVICES FEE SCHEDULE
|
| SERVICE |
Fee |
| Request for copy of notes (1) |
1. $30 (first 20 pages) + $0.25/page thereafter
2. Out-of-pocket disbursements (where applicable) are charged at cost. |
| Special letter/phone requests (2) |
To be determined prior to rendering the service. |
| OCF-3 (3) |
$144.20 |
| OCF-24 (4) |
$30 |
| Physiotherapy (PT), Occupational Therapy (OT), Biofeedback, Chiropractic (DC) (5) |
$90 (30 minutes)
$165 (60 minutes)
$200 (60 minutes, Biofeedback)
$240 (90 minutes) |
| Psychotherapy (RP) (6) |
$165 (60 minutes) |
| Missed appointments / Late cancellation (7) |
30 minutes or less (OT/PT/RP/DC)
60 minutes (OT/PT/RP/DC)
MD Appointments |
$50
$100
$100 |
|
Please note the following:
(1) Although the OMA does not exempt notes sent to your GP from this charge, we will not charge to send a copy of your notes to your GP by fax in two instances: after your initial appointment; and upon discharge back to your GP. Please note: individualized requests for notes are still subject to administrative fees.
(2) At times, you or your work may request a phone call or letter beyond a standard accommodations form. The fee will be commensurate with time required to complete the form. An example of this would be an Attending Physician Statements. Our office may not be able to handle any Short/Long-term disability forms; these are best handled by your GP.
(3 & 4) The rates for these forms (i.e., required for MVA patients) are set by the Ontario Medical Association’s guidelines for uninsured services. Payment in full is due before any service (i.e., completing the forms) is rendered and is non-refundable even in the event that the claim is denied.
(5) These services are rendered by a registered occupational therapist, registered physiotherapist along with an assistant, doctor of chiropractic at times with an assistant, that work interdependently with the entire team. There are surcharges for biofeedback equipment use. The Job Demand Analysis requires 2 x 1-hour appointments.
(6) This service is rendered by a registered psychotherapist that works interdependently with the entire team.
(7) This is strictly enforced. Because of the expense involved in bringing this service, we cannot afford to cover this expense for you in the event that you provide less than 24 hours notice of cancellation or fail to show up. While everyone has a good reason for not showing for an appointment, the expense for the same, even if for extenuating circumstances, will be borne by the patient/patient’s guardian for whom we reserved the appointment. Cancellations must be made by email and the timestamp on the email will be regarded as the official cancellation time. In the instance of group counseling courses, if you choose to de-enlist in the group counseling course, a $35 surcharge will apply to your reimbursement
