What is my coverage?
We’re often asked about coverage for physiotherapy, chiropractic, acupuncture and massage treatments. Everyone’s situation is different however there are some general guidelines that apply when determining what types of services might be covered. Many of our clients have coverage for physiotherapy, chiropractic, acupuncture and massage through their extended benefits providers. If you do have coverage there are usually yearly maximums in addition to percentage limits per visit and possible annual deductions. Be sure to confirm your limits and coverage amounts with your provider and/or human resources department! The usual procedure is to pay after each visit and then submit your receipts for reimbursement. We are able to direct bill for some providers and will require your benefit information and consent to do so.
MSP Premium Assistance
Only those MSP beneficiaries with 100%premium assistance status are eligible for a combined annual limit (each calendar year) of 10 visits for physiotherapy, massage therapy, chiropractic, and acupuncture. MSP only pay’s us a fraction of the cost for each service. You will have to pay a user fee for each visit.
Regular premium assistance offers subsidies ranging from 20 to 100 per cent, based on an individual’s net income (or a couple’s combined net income) for the preceding tax year, less deductions for age, family size and disability. If the resulting amount referred to as “adjusted net income” is $28,000 or below, a subsidy is available.
The current adjusted net income thresholds are:
$20,000 – 100 percent subsidy
$22,000 – 80 percent subsidy
$24,000 – 60 percent subsidy
$26,000 – 40 percent subsidy
$28,000 – 20 percent subsidy
We are an accredited Physical Therapy Provider and can complete assessments, treatments and “Return to Work” plans according to WCB protocols. If you have filed a claim for an injury at work your assessment and first treatment are covered. Any additional treatments must be authorized by WCB. There are very specific guidelines in terms of the number of treatments per week and the number of weeks that treatment is allowed. We will monitor this for you and keep you advised of any approaching limits.
When coming in for treatment we require all information that pertains to your claim: such as your claim number, date of injury, B.C. care card number, and a doctor’s referral. You must make sure you have filled out all of the appropriate paper work and send it into WCB. If you have not filled out your paper work you can go to www.worksafebc.com to find all the forms you require to start a claim. We require from all WCB patients a visa imprint so that if your claim is refused we have a payment option on file. If you have a claim number it does not mean that they have been approved. Once you come in we send our side of the paper work off to WCB. Then WCB will make decision on your claim. You can also check out the status of your claim on line. This process can take time. WCB will mail and/or call you with their decision. The sooner we can start therapy the better.
The first assessment/treatment will be covered by WCB whether the full claim is approved or not.
If you have been injured in a motor vehicle accident it is possible that you will have coverage for both physiotherapy, chiropractic and massage treatments. Insurers will require a prescription from a medical doctor prior to authorizing treatment. There are also a couple of different routes that coverage might take so it’s important to maintain communication with your adjuster to ensure coverage is in effect and exactly what has been authorized. We will assist you in confirming your coverage and will contact your Insurer whenever this will facilitate treatment. Insurance companies will sometimes authorize direct billing so you are not required to make payments “up front”. There is an ICBC user fee of $20 per visit. Regardless, it is important to make sure you are aware of any treatment limits and we will assist you in this regard.