Health Plans

As of April 2005 the Ontario Health Insurance Plan (OHIP) no longer offers funding for physiotherapy visits at most clinics.  

Services Covered by Extended Health Plans or Work Health Plans

Most insurance plans offer coverage for Physiotherapy, Massage therapy, Acupuncture, Chiropractic and custom Orthotics. These services and their specific coverage are usually outlined in your policy, providing you with information such as:

• the dollar amount allowed per visit and per year for each type of service
• the requirements and designation of the health care professional providing the service
• the yearly deductible portion for which the client is responsible
• if a written referral (by a physician) for the service is needed

You should also be able to call your insurance company with specific enquiries or look up information on their website. Your policy and identification numbers are required in order to access this information.

If you are claiming through your extended health care carrier or work plan, you will be required to pay for your therapy sessions upon each visit, after which you will be provided with receipts that you can submit for reimbursement.  While you do not require a doctor’s referral to attend Kanata Orthopaedic Physiotherapy Clinic, your insurance company may require one to process your claim.

Sports Medicine Consultations

All appointments with our Sports Medicine Physician are covered by OHIP.  Patients are required to bring a valid OHIP card to all their appointments.  Some fees may apply for non-OHIP services, including:

• Medical notes, forms
• Cortisone injections
• Synvisc injections

If You Are Hurt In a Motor Vehicle Accident

If you are involved in a motor vehicle accident, it is recommended that you begin treatment as soon as possible in order to allow for a quicker recovery from the time of the accident.

Upon assessment of your condition, your therapist will complete an initial report outlining his/her clinical findings, along with a treatment plan indicating types and length of treatment recommended. These documents will then be sent to your insurance adjuster for review before authorization of the entire treatment plan is given.

The aim of treatment is to return you to your previous level of function. Treatment will focus on active strengthening, stretching, conditioning, and pain-relieving modalities as needed.

Billing for Motor Vehicle Accident Insurance Claims

If you have extended health care benefits:

In Ontario, if you have an extended health care plan that covers any treatment you are receiving, motor vehicle insurance companies require that you claim through that plan first. Any remaining balances are then covered by your motor vehicle accident insurance plan. You will therefore be asked to provide this information when you come in for your assessment.

In this case, with your authorization, we may send claims to your extended health care plan on your behalf. Your motor vehicle insurer will require documentation outlining how much was covered by your extended health care benefits, so you may be asked to bring in this paperwork to the clinic. This documentation will allow us to bill any unpaid amounts to your motor vehicle insurer.

If you do not have any health care benefits:

If you do not have an extended health care plan which covers Physiotherapy, Chiropractic and/or Massage Therapy, your treatments can be billed directly through your motor vehicle accident insurance company.

If You Have Coverage through Blue Cross

Specific coverage is variable depending on the type of service received. Some treatments are fully covered, while others may require you to co-pay a certain amount. When you come in for treatment, you will be informed if you are required to co-pay any amount per visit.

On the initial visit, we will require:

• • a doctor referral prescribing the treatment to be received
  • your I.D. card
  • your signature on the claim forms which will be submitted to Blue Cross

Billing for Blue Cross Claims

Kanata Orthopaedic Physiotherapy Clinic is able to bill Blue Cross directly for Physiotherapy, Chiropractic and Massage Therapy treatments for members of RCMP, DND, Canadian Forces and Veterans Affairs, provided all billing requirements are met. For treatments that are only partially covered, you will be asked to co-pay the difference at each visit.