As of April 2005 the Ontario Health Insurance Plan (OHIP) no longer offers funding for physiotherapy visits.  Dynamic Balance Physiotherapy & Sports Injuries Centre is a private physiotherapy and massage owned practice. Our services are covered through extended or work health plans, motor vehicle accident insurance plans, WSIB (Worker's Safety & Insurance Board, formerly known as Workers' Compensation) or self-pay.

You do not require a doctor's referral to attend physiotherapy treatment, however, your insurance company may require one to process your claim.

Dynamic Balance Physiotherapy & Sports Injuries Centre ensures that each client receives quality care and is given sufficient time during each treatment to help maximize recovery.

Services Covered by Extended Health Plans or Work Health Plans

Most insurance plans offer coverage for physiotherapy, massage therapy, acupuncture and orthotics. These services and their specific coverage are usually outlined in a benefits handbook offered to you by your employer.

This handbook will provide you with the following information:

• 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. Your policy and/or identification number will usually be required, and sometimes your date of birth, before you are provided with the information.

If you are claiming through your extended health care carrier or work plan, you will be required to pay for your therapy sessions, after which you will be provided with receipts that you can submit for reimbursement.

Extended Health Care

If you have coverage through Blue Cross or Greenshield we can bill directly! Specific coverage however, 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. Alternatively you can call your insurance provider for details on the coverage amounts.

Motor Vehicle Accident

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

Upon assessment of your condition, a physiotherapist 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 extended health care benefits:

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

Workplace Injury

Dynamic Balance Physiotherapy & Sports Injuries Centre accepts Worker's Safety and Insurance Board (WSIB) claims if you are hurt at work.  If you would like to make a claim for an injury sustained at work, it is required that you report the incident to your employer as soon as possible and fill out the appropriate forms. It is advisable to visit your doctor who will recommend physiotherapy if needed. This recommendation should be forwarded to your employer as well as a WSIB case manager and/or adjudicator assigned to your claim. A review of your claim will determine whether physiotherapy treatment is authorized. Usually, up to 12 weeks of treatment is allowed.

Upon assessment of your condition, your physiotherapist along with your doctor, employer and WSIB nurse case manager will discuss and decide on the following issues:

• Appropriate time off work (if any) to allow for healing
• Return to work plan including possibility of modified duties for a specific time period or graduated hours until full time hours have been reached

Your physiotherapist may also be asked to fill out a Functional Abilities Form which describes what activities you can and cannot perform due to your injury.

Billing for WSIB Claims

Physiotherapy Treatments (per session)- $55.00

Acupuncture Treatments (per session)- $55.00

45 minute Treatment - $54.87+ HST

If you have any specific questions about our rates or your physiotherapy/massage coverage, please do not hesitate to call or email us.