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