Paying for prescriptions/referrals (OHIP)?

June 5, 2012 12:41 PM

Paying for a prescription to see a physiotherapist in Ontario?

I recently went to a walk-in clinic in Ontario. The doctor wrote me a "prescription to see a physiotherapist" (her words, I guess you could also call it a referral, except it wasn't to a specific person, just any physiotherapist). As I left the doctor said she needed to ask the front desk if I had to pay for the prescription. Which I did.

I'm not used to paying for prescriptions and was wondering why I had to, when I don't need the prescription to see a physiotherapist (I could have just gone straight to one).
I do have other insurance through work and I can claim the physiotherapy under this insurance, not sure if I can claim the prescription cost.

So to sum up: Why did I have to pay for a prescription (I don't necessarily need) to see a physiotherapist?

posted by devonia to Health & Fitness (6 answers total)

Best answer: My doctor has written a prescription for me to see a massage therapist so that my workplace insurance will cover the massage. I would need the same for physio. It is a way to prevent self-referrals and lower the insurance payouts. However, I have never had to pay anything for the note from my family physician; I believe OHIP does allow fees to be charged for prescriptions/notes like "so-and-so was too sick to work" and referrals for paramedical treatment. A walk-in clinic would have no incentive to offer notes for free if they are allowed to charge. Your insurance company will not refund the cost of the note. If you didn't want to pay you could have refused the prescription unless she made it free; but without the note then the insurance company probably won't pay your claims.
posted by saucysault at 12:54 PM on June 5, 2012

Response by poster: Thanks for the speedy reply! After seeing your answer I read some fine print on the walk-in's website. It says under extra costs "Notes for physiotherapy massage therapy (at the request of patient) = X$"

I guess this is a bit annoying because I didn't request the note, I told her my concerns, she recommended the physiotherapy wrote the note and charged me. Not enough money to worry about, I was mostly curious if this was a new thing (i.e., will all written prescriptions now cost me money) but I guess it might just be a walk-in clinic thing specifically for certain services.
posted by devonia at 1:14 PM on June 5, 2012

Did you pay for the note separately from paying for the appointment?
posted by gjc at 2:58 PM on June 5, 2012

Gjc, this is Ontario, the visit itself is covered under OHIP. Devonia was probably shocked at having to pay anything at a Dr's office.
posted by saucysault at 5:11 PM on June 5, 2012

devonia: The way you word things in your follow-up makes it sound like a pure scam. If I were you, I'd make a quick call to the CPSO (phone number under the first item here) to get their opinion. The fact that you didn't even request the note makes this all the more suspicious. Perhaps it's the default response to any complaint from any patient.
posted by matlock expressway at 8:23 PM on June 5, 2012

My very horrible doctor has a long list of things she likes to charge for. As well, the local walk-ins have some fees for some things, including referrals.

The logic behind this, in my understanding, is that most often people go in for a prescription to see a physio or massage therapist not because they require it to see these professionals, but because they need it to claim insurance (I do). With something like massage therapy, I think there is a perception that you don't really need it, and trying to reduce "wasted time."
posted by Gor-ella at 9:02 AM on June 6, 2012