Clinics located in Port Colborne & Ridgeway

The Ontario Health Insurance Plan (OHIP) provides coverage for a vast majority of physician services; however, there are some services that are not covered. Physicians are pleased to offer these valuable services; however, the responsibility for payment lies with the patient or the third party requesting the service.

Quality health care, medical advice and timely access are priorities that Ontario’s physicians intend to honour. Speak with your physician for more information about other health care services that are not covered by OHIP.

EXAMPLES OF SERVICES NOT COVERED BY OHIP

 

Medical Services

  • Routine eye examinations for patients 20 – 64 yrs of age
  • Examinations/diagnostic tests necessary to satisfy requirements requested by employers, insurance companies, government agencies, etc.
  • Pre-adoption examinations
  • Prescription renewals without a visit
  • Travel medicine advice and services for travelling outside of Canada
  • Telephone advice if initiated by the patient
  • Cosmetic procedures and related examinations and diagnostic tests

Completion of Forms and Medical Records

  • Medical/legal reports
  • Federal government forms
  • Certificates for the purpose of travel, immigration, employment, etc.
  • Driver’s/aviation medical exam and other licensing forms/certificates
  • Insurance forms, reports and certificates, such as:
    • Disability certificate
    • Treatment plan
    • Insurance medical examination reports
  • Completion of work and school related forms/notes, such as:
    • Sick or back-to-work notes
    • Admission to day care/schools/ recreational
    • Employer requested reports/forms (e.g., form physicals)

Administrative Services

  • Copying medical records, reports and letters at the patient’s request
  • Transfer or summary of medical records at the patient’s request
  • Missed appointments without sufficient notice

Block Fees

A block fee is defined as an optional flat fee charged by a physician for a predetermined set of services not covered by OHIP for a specific period of time. Not all physicians offer a block fee due to the nature of their practice and charge for each uninsured service when rendered. Speak to your physician for more information on block fees.

                     PATIENT GUIDE TO THIRD PARTY SERVICES UPDATED 2023
SERVICE FEE
Photocopying – for lawyer, insurance, other (pages 1-20)  $ 30.00
Photocopying – each additional page  $ 0.25
Copy of Chart on CD/USB  $ 40.00
Fee for Missed Appointment  $ 40.00
COMPLETION OF FORMS AND EXAMINATION FOR:  
Camp Physicals  $ 50.00
Fitness Clubs, Weight Loss Programs (Form only)  $ 40.00
Pre-admission to University / Educational Institution  $ 50.00
Pre-Adoption Examination for Children’s Aid Society  $ 300.00
COMPLETION OF PRE-EMPLOYMENT FORMS:  
Marine Medical Exam and Form Completion  $ 200.00
Ontario Driver’s Medical Exam (MTO)  $ 150.00
Pre-Employment Certification of Fitness  $ 150.00
Crane Medical Exam and Forms  $ 150.00
License Suspension Appeal Form (and up depending on detail)  $ 50.00
COMPLETION OF WORK AND SCHOOL RELATED NOTES AND FORMS  
Sick Note  $ 40.00
Day Care Note (Free from Communicable Disease)  $ 50.00
Exemption from Jury Duty  $ 60.00
Canadian Armed Forces / DND Medical Info Request  $ 100.00
School Administered Medication Report  $ 40.00
OTHER FORMS AND CERTIFICATES  
Private Insurance – Sickness or Disability Forms  $ 60.00
Repeat Forms, Same Illness  $ 50.00
Attending Physicians Statement  $ 160.00
Full Medical Exam and Report (per hour)  $ 400.00
Health Practionitioner’s Certificate OCF-3/59  $ 164.00
Treatment Plan Form OCF-18/59  $ 164.00
Clarification of Narrative Report (per hour)  $ 400.00
HRDC Disability / Maternity Certificate  $ 40.00
EI Compassionate Care Benefit  $ 40.00
CRA, Federal Disability Tax Credit Form  (Form 2201)  $ 200.00
CPP Disability Medical Report (ISP2519) ( Billed to CPP)  $ 85.00
CPP Update (ISP2551) See billing guidelines  $25 – $150 
Vehicle Retail Sales Tax Refund Form  $ 40.00
CRA Medical Expense Tax Credit Report  $ 60.00
Travel Cancellation Form  $ 50.00
Life Insurance OR Certification of Death  $ 60.00
Interview with Third Party (per hour)  $ 350.00
Prescription Authorization (per medication)  $ 10.00
Certificate of Life  $ 60.00
Waste Exemption Form  $ 40.00
Device or Treatment Authorization  $ 40.00
Consultations and Other Uninsured Requests (per hour)  $ 400.00
UNINSURED PROCEDURES  
Urine Pregnancy Test  $ 5.00
TB Testing (For Employment Only 1 or 2 step)  $ 60.00
Ear Wax Removal (per ear)  $ 20.00
REMOVAL OF COMMON WART, BENIGN / MINOR SKIN LESIONS  
Liquid Nitrogen (First 1-5 Lesions)  $ 60.00
Liquid Nitrogen (6-10 Lesions)  $ 100.00
Excision and Suture (cutting) First lesion)  $ 120.00
(Each Additional Lesion)  $ 60.00
Electrocoagulation (Burning)  $ 80.00
(Each Additional Lesion)  $ 40.00
CONSULTATIONS AND ASSESSMENTS – SELF PAY  
Pre-Op Assessment / Pre-Dental Assessment  $ 100.00
Minor Assessment  $ 63.05
Periodic Health Exam  $ 227.11
General Assessment (A “Physical”)  $ 227.11
Consultation  $ 228.54
Intermediate Assessment  $ 95.85
PAP Test (plus lab processing fee)  $ 50.00
House Call Assessment (Plus Travel / Time Premiums)  $ 150.00
Travel Health Advice (Immunizations are extra)  $ 60.00
Travel Health Immunizations (per injection)  $ 20.00
Expert Witness Travel Time (per hour)  $ 400.00
Expert Witness Preparation Time (per hour)  $ 400.00
Expert Witness Fee  $ 400.00