Ontario Medical Association (OMA) Guidelines Charges

Transcription

Ontario Medical Association (OMA) Guidelines Charges
Charges for Uninsured Services (NOT COVERED BY OHIP)
Ontario Medical Association (OMA) Guidelines
TYPE OF SERVICE
Completion of Form Physicals for:
Schools/Camps
DESCRIPTION OF UNINSURED FORM/REPORT/SERVICE
FEE
$26.00
Admission to Day-Care, Preschool, University or any other educ-al institution
$26.00
Pre-employment Certification of Fitness/Fitness Clubs
$34.00
Hospital/Nursing Home Employees
$34.00
Drivers Medical Examination
Completion of Licensing
Forms/Certificates:
Civil Aviation Medical Examination Report
Pilots License Validation
Administrative License Suspension Appellant Medical Info. Form
Back to Work Notes/Sick Notes
Completion of Work and School
Federal Employee Absence Notes
Related Forms/Notes:
$52.00
Physician hrly
rate
Physician hrly
rate
$40.00
$18.00
$26.00
Day Care Note (free of communicable disease)
$18.00
OCF-18 Treatment Plan
$130.00
OCF-3 Disability Certificate
$130.00
OCF-19 Determination of Catastrophic Impairment
$107.00
Insurance Certificates: (Note: An OCF-22 Approval of an Assessment
assessment fee can be charged in Travel Cancellation Insurance Form
$122.00
addition to the insurance form fee
if an assessment is necessary to
obtain relevant information
needed to complete the form)
$44.00
Life Insurance Death Certificate
Medical Certificate for Employment Insurance Compassionate Care Benefits
$50.00
Attending Physician’s Statement
$130.00
System – Specific or Disease Specific Questionnaire
$87.00
Insurance Medical Examination
$212.00
System-Specific Examination
$104.00
Full Narative/Clarification Report
Citizen and Immigration Canada Medical Report for Immigration
Government Forms:
Other Certificates:
$349.00/hr
$130.00
CPP Disability Medical Report Form
$85.00
CPP The Narative Medical Report
$150.00
Request for Medical Information re: Applicants to Canadian Armed Forces
$102.00
Central Collection Service Request for Physician’s Information
$130.00
Revenue Canada, Federal Disability Tax Credit
$44.00
Auto Sales Rebate Form
$35.00
Children’s Aid Society Application for Prospective Foster Parent
$52.00
Medical Certificate Employment Insurance Sickness Benefits
TB Test requested by Ministry of Health Program (eg. Public Health)
TB Mantoux Testing***
$35.00
TB Test requested for admission or continuation in a day care, pre-school, school, college, university or
other educational institution. TB Test Insured by OHIP. Charge for Form/Report Completion
TB Test requested for employment purposes (Test + Form)
$26.00
OHIP covered
$20.00
$45.00
Application for Accessible Parking Permit/Transit Forms for Disabled
Unremunerated Report Forms:
(Physician is NOT permitted to PR Card Forms/Request for Birth Certificate Form/Canadian Passport Application
charge a patient for completion) Children’s Aid Society Form (on behalf of a child)/Ministry of Health and Long-Term Care (eg. Limited Use,
Assistive Devices etc.)
Copies from the Patient’s Chart (up to 20 pages)
Chart Copies:
Copy of the Full Chart (over 20 pages). $30.00 + $.25 per page for each page over 20 pages.
Letter for massage therapy, orthotics, back support, stockings etc.
Missed Appointment
Other:
PAP Test***
No Charge
$1.00/pg.
$30.00 +
$0.25/pg.
$30.00
$40.00
Lost requisition/Referral
$5.00
Fax Prescription refill
$15.00
Travel Advice and Vaccine Administration (must be purchased from Pharmacy)
$65.00
Charge for PAP Test by Physician
$36.00
Processing Fee - payable directly to Processing Laboratory (e.g. CML)
$20.00
*** MAYBE COVERED BY OHIP IF CERTAIN CRITERIA ARE MET