Frequently Asked Funding Questions

pt Health accepts government funding streams (such as AHS, ICBC, and OHIP) as well as motor vehicle accident insurance, health benefit plans, WSIB/WCB, and Veterans Affairs. Our services are covered by most health benefit plans.

We have many clinics in Ontario that accept OHIP patients. However, there is a certain criteria you need to meet to qualify for OHIP coverage. You must also have a referral from a doctor or nurse practitioner. The criteria is as follows:
• Age 19 or younger
• Age 65 or older
• Post hospital stay (you must have been admitted for at least 24 hours).
• On ODSP or Ontario Works

Submit your Accident Benefits Package (OCF 1) to your insurance company as soon as possible. Click this link to download the OCF1 form: http://www.fsco.gov.on.ca/en/auto/forms/Documents/SABS-Claims-Forms/1224E.2.pdf
When you call pt Health to book an appointment, we’ll need the following information:
• Name of insurance company
• Claim number
• Policy number
• Adjuster first and last name
• Date of loss
Once that information is provided, we’ll be able to process your claim.

If you are a WSIB/WCB patient at pt Health, you’ll receive timely access to a thorough assessment, a comprehensive outcome-based rehabilitation plan, and claim services for your injuries.

pt Health services – physiotherapy, massage therapy, acupuncture, chiropractic, and other services – are covered by most health care plans. Typically, these plans cover 80%-100% of the cost for the service. If you have a dental plan, chances are you also have coverage for many of the services and products we offer.

pt Health is able to offer direct billing for many insurance providers. However, it is dependent on your insurance company and their billing policy. If your individual policy and insurance plan allow for direct billing and assignment of benefits to the clinic, we will be able to do the billing for you.

Unless you are an OHIP patient in Ontario, you do not need a doctor’s referral for physiotherapy. However, if you are going to use your health insurance to cover the cost of therapy, the insurance provider may ask you for a doctor’s referral.

pt Health has two easy options. Too book online, click on this link: http://pthealth.ca/appointment-booking. You can choose the clinic, service, date, and time that works best for you and one of our patient care representatives will call you back to confirm your appointment.
You can also call 1-866-749-7461 directly and one of our patient care representatives will be able to schedule an appointment at any of our clinics across Canada. We will find the services you need at the location that is most convenient for you.

Our policy is to get our patients an appointment as soon as possible. In many cases, we’ll be able to get you in the same day you call. If that isn’t possible, the longest you’ll wait is few days. The only exception is if you are an OHIP patient. Because of the way the OHIP is structured by the Ontario government, there is typically more of a wait. However, there are cancellation lists at the clinic, so your chances of getting in sooner are much higher.

Your first appointment will be an assessment. You’ll be asked to arrive 15 minutes early and to wear loose, comfortable clothing. All of our clinicians are registered with a professional college and/or regulatory body and have a lot of experience treating patients with a wide variety of injuries and/or conditions. They’ll do a thorough medical intake and will take a complete history. They will also do a physical assessment to determine the range and scope of your injury or condition. After that is complete, your clinician will work with you to develop a treatment plan that best suits your needs and goals.

Not necessarily. Everyone is different. The first thing your clinician will be focused on is reducing and managing any pain you may be experiencing. Some patients might experience relief at their very first appointment. However, it takes time for the body to heal and strengthen optimally. Typically, it takes a few treatments before you’ll start to notice a real improvement. Don’t be discouraged! This is part of the process. At the end of your treatment, you’ll see significant change in your level of function and a positive outcome.

We ask that you give us 24 hours notice when cancelling an appointment. This will allow us to fill your spot with patients that might be on our waiting list. Cancellation fees are at the discretion of the clinic.