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 requests (2) |
To be determined prior to rendering the service. |
| OCF-3, OCF-18 (3) |
$144.20 |
| OCF-24 (4) |
$30 |
Occupational/
Vision Therapy (5) |
30 minutes
60 minutes |
$90
$165 |
| Psychotherapy (60 minutes) (6) |
$165 |
| Cognitive Assessment (60 minutes) |
$200 |
| Buffalo Treadmill Protocol (7) |
$165 |
| Vision Therapy Kit + Lens exchange program (8) |
$200 |
Missed appointments
/ Late cancellation (9) |
20 minutes
40 minutes
60 minutes |
$50
$100
$150 |
|
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 after your initial appointment and upon discharge back to your GP.
(2) At times, you or your work may request a 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) Vision therapy will be rendered by a specialized optometrist and/or a registered physiotherapist trained in vision therapy and will be managed by the entire team: medical doctor, allied rehab providers and optometrist.
(6) This service is rendered by a registered psychotherapist that works interdependently with the entire team.
(7) More information about this test, done by our Physiotherapist, MD and Rehab assistant, can be found on our
website in the article titled Buffalo Treadmill Protocol.
(8) The vision therapy kit includes all the equipment you will need for the duration of your vision therapy. It also includes a lens flipper exchange program so that as you progressively improve, you can trade in your lenses for another, saving you from buying another. The flipper you turn in will have to be deemed to be in a satisfactory condition to be reused.
(9) 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.
