We’ve Got You Covered
We Take Care of the Paperwork so You Don’t Have To!
pt Health services are covered by most health care plans. Typically, these plans pay 80-100% fee for service. If you have a dental plan, chances are you also have coverage for many of the services and products we offer at pt Health. pt Health also accepts auto insurance, Work Safety Insurance Board (WSIB/WCB) and, in some cases, Veterans Affairs and Medicare – such as OHIP (Ontario), Alberta Health Care and Medical Service Plan MSP (British Columbia).
Employer Extended Health Plans / Benefits
pt Health services are covered by most health care insurance plans. If your insurance company allows direct billing and payment we will look after the billing for you. If your insurance company will not allow direct billing and payment you will pay the clinic and submit to your insurance company, however we will assist with your paperwork to make it easier for you.
Motor Vehicle Accident Coverage- billed directly for your convenience
If you have extended health care benefits that cover therapy, most auto insurance companies require that your claim be placed through your extended health plan first. Any remaining balances for services are then covered by your auto insurance plan. On your first visit, you may be asked to provide information about your extended health plan. If you do not have extended health care benefits which covers therapy, your treatments may be billed directly through your auto insurance company.
For residents of British Columbia, ICBC covers a partial amount of treatment visits. Patients will be asked to co-pay the difference at each visit. If a patient has extended health care benefits, it is possible to claim the difference back
Workplace Safety Insurance Board (WSIB/WCB)- billed directly for your convenience
WSIB/WCB provides physiotherapy coverage for workers injured on the job. We bill WSIB/WCB directly for treatments provided, complete necessary forms, progress reports and treatment extensions. We communicate with adjudicators, your workplace and other healthcare professionals involved in your treatment. Our team can help you navigate through any WSIB/WCB paperwork that you may be unsure about.
OHIP (Ontario Health Insurance Plan)
Effective August 22nd, 2013, the Ontario Ministry of Health changed how physiotherapy services are being funded. The new model, described as an “Episode of Care”, will consist of a block of physiotherapy treatments provided to patients that meet the OHIP criteria. Learn more about OHIP.
The number, frequency and duration of visits offered during each episode of care must be necessary and reasonable for the treatment of your condition. Your physiotherapist will use their clinical judgement and evidence-based best practices to make that decision. Keep in mind, this program does not cover services aimed to maintain an existing level of function. A new referral from a physician or nurse practitioner is required for each episode of care.
The eligibility criteria for OHIP is the same:
- Age 65 or over
- Age 19 or younger
- Post Hospital stay
- On ODSP or Ontario Works
Blue Cross Billing
At some pt Health clinics, we will bill Blue Cross directly for physiotherapy and massage therapy treatments for members of:
- Canadian Forces
- Veterans Affairs
For any treatments partially covered, you may be asked to co-pay the difference at each visit.
For more questions about treatment fees and/or payment options, please contact our helpful administrative team! We are always happy to speak to you.
* All British Columbia locations do require you to pay for your therapy sessions up front. You are given a receipt for each treatment that is reimbursed by your extended health care provider.