Case of the Month

Read real cases and their outcomes

  • Pay My Physio Bills

    Nov 20, 2019

    The Case

    The College received a complaint from a patient who was attending physiotherapy following a motor vehicle accident. The patient was surprised when her sessions stopped after a few months as she exceeded the maximum funding available from her insurance provider. 

    Although the patient didn’t have any issue with the care she received from the physiotherapist, she indicated that she did not see a billing summary until after receiving treatment, that she did not understand the fee structure, and that she was charged unnecessarily high fees for items like “preparation” and “concussion kit.” 

    The patient did not understand how approximately 30 sessions over the course of a few months could amount to nearly $4,500. As the services outlined in her bills were largely undefined and not attributed to a specific physiotherapist and she was unsure what she was being charged for. 

    The PT said that the patient was advised of the fee structure before starting treatment. He also provided copies of the signed OCF-18 form that highlighted the $99.75 hourly rate for physiotherapy as outlined by the Financial Services Commission of Ontario as well as the clinic’s billing policy and procedures form. The physiotherapist noted that the hourly fee did not include any preparation, planning or administrative tasks which were billed as additional costs. The PT specified that this is standard practice for the clinic.

    The patient record listed additional costs like the completion of the OCF form, administrative costs for approximately $25 for each occurrence and a concussion kit for $800. 

    The Standards

    The College’s Fees, Billing and Accounts Standard states that physiotherapists are accountable for any fee, billing or account that uses their registration number. PTs must also ensure that any fee, billing or account that uses their name and registration number is an accurate reflection of the services and products provided. They must never charge fees or create billings or accounts that are inaccurate, false or misleading.

    There must be a written fee schedule for each funding stream including fees for assessment, reassessment, treatment, other services or products and administrative tasks. The fees must not be excessive. Before providing care, physiotherapists must ensure that patients are given clear information about fees, and that they understand the information.

    The Outcome

    In reviewing the available evidence, the College was satisfied that the PT discussed the fees and billing structure with the patient before starting treatment and no action was taken.  

    It is unfortunate that the patient’s insurance was no longer accessible for treatment, however the majority of the fees over the course of her treatment did not seem excessive. Additionally, she did sign the OCF-18 form and the clinic’s billing policy and procedure form and checked the boxes that indicated she had a discussion with the PT about fees and billing. 

    The College did make note of the relatively high fee for the concussion kit and encouraged the physiotherapist to review the fee for that service and make improvements if possible. 

    Fees, Billing and Accounts Standard
     

     

     
    Full story
    • fee structure
    • complaint
    • patient
    • concussion kit
    • accounts
    • billing
    • fees
    • Case of the Month
  • All Together Now

    Oct 08, 2019
    Full story
    • physiotherapist
    • physiotherapy
    • neurological
    • hospital
    • record keeping
    • Case of the Month
    • collaborative care
  • When a Quick Favour Becomes a Complaint

    Sep 09, 2019
    Full story
    • complaint
    • treatment
    • assessment
    • physiotherapy
    • regulated health professional
    • favour
    • Case of the Month
    • record keeping
    • Consent
  • Surprise, Your PT is Delisted

    Aug 15, 2019
    Full story
    • ethics
    • accounts
    • billing
    • fees
    • Fraud
    • physiotherapy
    • Case of the Month
    • physiotherapist
    • Delisted
    • benefits
    • insurance
  • Ticking a Box Isn’t Enough

    Jul 15, 2019
    Full story
    • Case of the Month
    • physiotherapist
    • patient
    • Communication
    • complaint
    • PTA
    • working with physiotherapist assistants
    • supervision
    • Consent
  • Faking It

    Jun 07, 2019
    Full story
    • Consent
    • Assessments
    • billing
    • holding out
    • working with physiotherapist assistants
    • supervision
    • PTA
    • physiotherapist assistant
    • Case of the Month
  • Supervising a Forgetful Student

    May 07, 2019
    Full story
    • Case of the Month
    • supervisor
    • student
    • physiotherapy
    • Consent
    • infection control
    • supervision
  • The Clinic Owner Doesn’t Always Know Best

    Apr 10, 2019
    Full story
    • supervision
    • PTA
    • physiotherapy competency exam
    • physiotherapist assistant
    • assessment
    • independent practice
    • provisional practice
    • physiotherapist
    • holding out
    • Case of the Month
  • No Notes is Bad News

    Mar 18, 2019
    Full story
    • Case of the Month
    • ethics
    • Delisted
    • insurer
    • Consent
    • registration number
    • billing
    • fees
    • record keeping
  • Missing: Consent, Communication and Acknowledgement

    Feb 19, 2019
    Full story
    • complaint
    • treatment
    • Consent
    • Boundaries
    • physiotherapy scope
    • Communication
    • Case of the Month
  • Float On, but Don’t Say it’s Physiotherapy

    Jan 23, 2019
    Full story
    • insurance
    • Delisting
    • registration number
    • billing
    • fees
    • scope of practice
    • float therapy
    • physiotherapy
    • Case of the Month
  • There is Such a Thing as Too Friendly

    Dec 11, 2018
    Full story
    • patient
    • physiotherapist
    • relationship
    • friendship
    • professional boundaries
    • therapeutic relationship
    • record keeping
    • informed consent
    • Consent
    • mechanical traction
    • insurance
    • accounts
    • billing
    • fees
    • Boundaries
    • Case of the Month
  • When Acupuncture Goes Very, Very Wrong

    Nov 13, 2018
    Full story
    • physiotherapist
    • physiotherapy
    • acupuncture
    • Case of the Month
  • 1,200 Hours Short of a Certificate

    Oct 19, 2018
    Full story
    • Ontario
    • College of Physiotherapists
    • physiotherapist
    • Case of the Month
    • practice hours
    • registration
    • certificate
  • Can’t We All Just Get Along?

    Sep 17, 2018
    Full story
    • specialty designations
    • restricted titles
    • PTA
    • physiotherapist assistant
    • physiotherapist
    • physiotherapy
    • relationships
    • collaborative care
    • Case of the Month
  • Don’t You Forget About Me

    Aug 21, 2018
    Full story
    • ICRC Committee
    • essential competencies
    • physiotherapy
    • acupuncture
    • Case of the Month
  • Caught Up in the Cryo Hype

    Jul 18, 2018
    Full story
    • physiotherapist assistant
    • advertising
    • billing
    • physiotherapy
    • cryotherapy
  • You Can’t Laser Over History

    Jun 14, 2018
    June 2018 Case of the Month from the College of Physiotherapists of Ontario. The case outlines the use of laser therapy on a patient with a history of melanoma.
    Full story
    • physiotherapist
    • College of Physiotherapists
    • essential competencies
    • record keeping
    • laser therapy
  • The Snowball Effect

    Feb 20, 2018
    Full story
  • No Laughing Matter

    Dec 11, 2017
    Full story

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