- Basic Care
- Regular Visit
- Comprehensive Visit
- Complex Visit
Most patients are unaware of the benefit from their insurance plans and other funding sources. Contact our team and we can help. ask@albertaPT.com . Below are the 4 most common ways of accessing physiotherapy care.
For patients who have Group Insurance, the benefits for physiotherapy range from 100% coverage, to partial coverage with deductibles. When looking into your plan, you will need to know:
If you have a health spending account, you will need to ask your employer your yearly maximum amount and who to submit your receipts to. Many employers will offer both the Group Insurance and the Health Spending Account so that access to physiotherapy is fully covered.
For patients who are married and both partners have insurance, the process can be somewhat more complicating and does vary from case to case. To maximize your benefits, you should talk to the clinic administrator prior to your visit.
All AlbertaPT clinics provide direct billing to insurance if available.
Accessing funding does require paperwork to be completed by both the patient and the physiotherapist. If you are assessed within 10 days of the car accident, you can qualify for either the WAD 1 or WAD 2 in-protocol programs. For out-of-protocol programs of care, legislation requires private insurance be accessed first, with the remaining unpaid balance covered by the Automobile Insurance.
The rate charged per visit will vary depending on the level of care and the amount of data collection required. When in-protocol, you are covered for the Regular Visit Rate. When out-of-protocol, you are covered by either the Comprehensive Visit or Complex Visit Rate.
Navigating the Automobile Accident Insurance Benefits and dealing with adjusters can be a complicating process. Let our Care Coordinator assist you with the process.
If all the required paperwork is completed, most acute injury claims are approved. For chronic conditions, pre-approval of services are required prior to treatment.
The mandate of WCB is return to work and exercise. As such, the WCB fee is for a Basic Visit only. In certain cases where more than 2 areas are injured, WCB may recognize a modified Comprehensive Visit. During a WCB visit, the physiotherapist is only to treat the areas recognized in the WCB claim.
Patients qualify for 3 PCN Basic Visits (limited to PCN Accepting Clinics) if:
- The referring physician is part of the Mosaic PCN and provides the Yellow Physiotherapy Card