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The Common Denominator: Billing, Registration, Professional Identity

Sep 07, 2017

Jamie G. Dockx, PT Student
Clinical placement at the College of Physiotherapists of Ontario

 

I have had the privilege of spending 5 weeks at the College of Physiotherapists of Ontario for my final student placement. After 4 clinical placements, it was time to learn the ins and outs at the College.

Learning about the registration process was of particular interest, as I plan to apply for a provisional practice certificate in the near future. In collaboration with Communications, Registration and Practice Advice, I organized a resource to assist applicants through the process.

In doing this, I realized that billing, registration, and professional identity had a similarity or common denominator: a physiotherapist’s registration number.

Throughout my academics, I have always been told to keep my student number to myself. This gave me some control over how this number could be used by others.
In the case of a registered physiotherapist in Ontario, their registration number can be easily accessed by the general public; it’s part of their professional identity.

What was unsettling to learn was that this registration number is the same number used to bill for physiotherapy services.

Sadly, registration numbers continue to be used inappropriately. For example, the College has received complaints describing how registration numbers continues to be used at previous and/or current sites of employment for physiotherapy services that were not provided.

At the end of the day, a physiotherapist is responsible for any fee, billing, or account that uses their name and registration number.

The Fees, Billing, and Accounts Standard attempts to help physiotherapists with this responsibility by making it mandatory to have a written process of routinely reviewing the accuracy of their fees, billings, and accounts. All employers have a duty to make this information available to you.

Further, the College has experienced practice advisors to assist physiotherapists in reducing the risk of inappropriate billing behaviour. In fact, questions concerning fees, billing, and accounts rank as the 3rd most frequently asked practice advice question.

This ranking is an indication that physiotherapists are taking an active role in protecting the use of their registration number.

As a final piece of advice, be upfront with your employer about how your registration number can be used to bill for physiotherapy services and have written documentation of this discussion. 

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  1. J | Oct 26, 2017
    According to a college advisor, having patient treatment get billed under my number when I had no recollection of meeting the patient was a grey area. After that I lost hope in the college for any advise. As stated the college serves and looks out for the public, but who will look out for therapists? Fraudulent and questionable billing is far too common in private practice, but the college seems to not take any significant action on that matter. I like Rob's suggestion in a previous comment about having a way for physio to at least see what clinics are billing under their name by date.
  2. H P | Sep 25, 2017

    thank you Jamie for sharing your thoughts and opinions.

    I am glad that I don't work in a clinical setting and therefore, it is a relief that I don't have to worry about the "billing" nightmare. But I have definitely heard too many horror stories.

    what you are saying makes sense in an ideal world, where everyone goes by the books! unfortunately, real life is very different and a lot of PTs work in clinic as they don't have any other option to earn their bread-butter. Majority of PTs are themselves a victim of fake billing, but they are suspects in the eyes of college. It is very easy to talk about ideals and ethics, sitting in an air-conditioned office! in real life, the pressure from employers, families, clients, ministry, organization, etc is intense and a lot of PTs buckle!

    why cant college come up with a regulation that states that PTs have to personally sign each and every invoice for it to go through? this way the PTs will be in the know! (same way they want invoice to have details of all health care professionals involved in care including PTAs)

  3. Ankita | Sep 14, 2017

    Thanks for providing opportunity to leave a comment.

    In current out patient physiotherapy practice, the business owner is empowered.

    There is no direct contact between the insurance company and the licensed physiotherapist. 

    If physiotherapist can directly register them self for online billing/ insurance company so the insurance company can contact the license service provider directly, because at current situation the clinic owner is taking that place.

    Second thing is if the PT can update the change in employment place directly with insurance company (like updating the employment information with college of PT) might prevent fraud billing.

    I will request the college to create some rules to protect the registered physiotherapist license, if the license no is public then provide the some billing no. which is only in control of physiotherapist like password.

  4. Rob | Sep 07, 2017

    I have always shared the concern that our billing number is such public knowledge. Former employers can use it and the Physiotherapist is completely unaware and has no way of verifying it is not being used (other than to rely on the word of the former employer). It is clearly in the public interest that Physiotherapy billing numbers are used appropriately. Why does the College not seek to develop a reporting scheme that compels extended health care insurance companies, the WSIB, OHIP and MVA insurers to provide a report of all the billings received under each number (quarterly). A quick review by the therapist would let them know if things are out of whack and someone was using their number inappropriately.

    These institutions all claim they are victims of billing fraud. A step such as this would surely help them in this battle. Will we see the College step up to measures like these?

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