ON Chiropractic
Not Recommended by the OCA
The OCA does not recommend delaying treatment until a claim is approved , nor does it recommend billing patients while a claim is pending . Neither of these courses of action are in the best interests of the patient .
Treatment timing should be guided by clinical recommendations , not insurance coverage decisions .
If you bill a patient directly and the claim is later approved , you will need to reimburse them . In certain cases , they may have already received compensation from their extended health insurer and this would also need to be reimbursed . These complications are best avoided by waiting for a claim decision before billing .
Please note that billing a patient for services provided under an approved claim is prohibited under section 33 ( 5 ) of the Workplace Safety and Insurance Act which states “ No health care practitioner shall request a worker to pay for health care or any related service provided under the insurance plan .” When a claim is approved , it is approved from the date of injury forward ( not the date of approval ) so any money the patient has paid must be reimbursed .
PATIENT BILLING RESPONSIBILITY IN CASE OF WORKPLACE INJURIES
I UNDERSTAND THAT IT IS MY RESPONSIBILITY TO :
1 . |
Report my workplace injury to |
2 . |
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my employer . |
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IF MY CLAIM IS DENIED , I FULLY UNDERSTAND AND EXPRESSLY AGREE THAT I WILL BE PERSONALLY RESPONSIBLE FOR THE FULL COSTS OF SERVICES .
PATIENT NAME :
PATIENT SIGNATURE :
DATE :
WITNESS NAME :
WITNESS SIGNATURE :
DATE :
Report my workplace injury to WSIB and ensure that they have all of the forms they need to process my claim .
Please visit our website to download our sample patient form , Patient Billing Responsibility in Case of Workplace Injuries .
Please note : The Health Professional Access Line at 1-800-569-7919 is best used for questions about the Programs of Care . For inquiries about individual claims , call the General Inquiry Line at 1-800-387-0750 .
DOWNLOAD
WSIB Claim
Download this form at www . chiropractic . on . ca / members / managing-yourpractice / patient-coverage / wsib /. www . chiropractic . on . ca 17