Physiotherapy clinics are private rehabilitation facilities. You have direct access to physiotherapy and do not require a referral from your physician.
Your physiotherapy treatment may be in part or fully covered in certain situations:
- Were you hurt at work? Your treatments may be covered by The Workers Compensation Board (WCB)
- Were you hurt in a Motor Vehicle Accident (MVA)?
- Extended Health Benefits
- Alberta Health Services (also low income, ortho: fracture, surgery)
If you were injured while at work, you may be able to file a claim to the Workers’ Compensation Board (WCB)*.
In order to file a successful claim you must:
- Report your injury to your employer and ensure that your employer submits a Report of Accident to WCB.
- Complete a Worker’s Report of Accident and submit it to WCB
- See your physician (or company physician), inform him/her that you were injured at work and then he/she will complete a report and submit it to WCB
- See your Physiotherapist for an initial assessment of your injuries (which is covered by WCB). Your physiotherapist will submit an assessment report to WCB.
Once your claim has been approved, your WCB Adjudicator/Case Manager will typically authorize physiotherapy for a certain number of visits or certain period of time based on your injury. You are required to attend regular physiotherapy treatments as directed by your physiotherapist.
*If you were hurt at work out of province, please inform us at the time of your booking in which province the injury took place. Your claim must then be filed with the appropriate provincial injury board. eg. WorkSafeBC
If you have been involved in a motor vehicle accident (MVA) and have sustained any injury you must:
- Report your accident and any injuries to your insurance company.
- Next, you should arrange an assessment with your primary healthcare practitioner (your physician, physiotherapist or chiropractor) who will discuss your treatment options.
Physiotherapy treatment is dependent on your initial diagnosis, and may be accessed through either Diagnostic & Treatment Protocols or Section B Protocols.
Diagnostic & Treatment Protocols
If you are diagnosed with Whiplash or another soft tissue injury eg. sprain or strain, your treatments can be claimed under the Diagnostic & Treatment Protocols.
You will need to complete a Notice of Loss & Proof of Claim form (AB-1) and return it to your insurance company within 10 days from the date of your accident.
Based on the degree and severity of your injury you will be granted up to 10 or 21 treatments at the expense of your motor vehicle accident insurance company. These treatments must be completed within 90 days following the date of your accident.
Section B Protocols
If you are diagnosed with any other injuries other than a soft tissue injury, such as a fracture, your treatments will be claimed under Section B.
You will need to complete a Notice of Loss & Proof of Claim form (AB-1) and return it to your insurance company within 30 days from the date of your accident.
If you have any extended health benefits coverage, you will be required to exhaust them prior to accessing coverage under Section B. Any further medical expenses coverage will require approval from your MVA Adjustor.
Please note: There may be treatment limitations in regards to Chiropractic, Massage, or Acupuncture treatment under Section B.
Your extended health benefits plan may cover the cost of physiotherapy (splinting, acupuncture, or massage) in part or in whole.
Please contact your extended health insurance company to determine whether
- Physiotherapy is covered under your plan.
- What is your benefit year (eg. January 1 – December 31)
- What is the annual maximum for your physiotherapy coverage (eg. $500/year)
- What is your treatment maximum (eg. $50/session)
- What is the percentage coverage (eg. 80%/session)
Depending on your extended health insurance company you may be eligible for reimbursement, direct billing, or online billing.
Typically, you will be required to pay for your session at the end of your visit. You will need to submit a claim form, invoice and original receipt to your insurance company. Once your extended health company receives the required paperwork, they will then reimburse you. The amount reimbursed is dependent on your plan coverage for physiotherapy treatments.
Some extended health insurance companies allow us to direct bill online for services rendered (eg. Blue Cross). You may need to sign an authorization form allowing our clinic to direct bill online. The amount covered is dependent on your plan coverage for physiotherapy treatments. Once the claim is processed, you will be given a statement along with an invoice that will state the amount to be paid by the extended health company and the remaining amount not covered that you are responsible for paying.
Please feel free to contact our office to see if your extended health plan allows direct billing for physiotherapy, splinting, acupuncture or massage.
Treatment costs not directly covered by your extended health insurance plans will be billed directly to you, the patient. You may pay by Cash, Debit, Visa or Mastercard. You will be given an invoice and receipt of payment.
Our clinic is happy to provide you with an Alberta Health Services funded assessment for physiotherapy. You are eligible to receive one assessment per treatment site per year (April 1 – March 31). Following your assessment, your Physiotherapist will fill out the Determination of Need (DON) form and determine your eligibility for two additional Alberta Health Services funded treatments.
In some cases you may qualify for additional four Alberta Health Services funded visits including: if you had a fracture (broken bone), if you recently underwent surgery, and low income situations.
Please note: Funding for these sessions are limited through Alberta Health Services and you may be placed on a waiting list*to receive the next available funded assessment.
*There are no wait lists associated with funding if you have qualified for fracture, surgery, and low income sessions.