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Fee Schedule for Jaconello Wellness Centre

PAYMENT FOR SERVICE

A portion of the visit is covered by OHIP. A separate cost applies when complementary topics are discussed, as there are areas of therapy that would be considered innovative and thus not covered by OHIP.

There are areas of therapy that would be considered innovative and thus not covered by OHIP. These include:

  • Advice and treatment of toxic metal body burden and their removal.
  • Advice on the treatment of autism including diets, nutrient therapy and chelation of toxic metals.
  • Advice on the treatment of cardiovascular disease with EDTA chelation therapy.
  • Implementation of nutritional detoxification programmes.
  • Advice and treatment of non-atopic food allergies as related to elimination diets, environmental precautions and the use of low dose immunotherapy in their management.
  • Advice related to the use of nutritional supplements both orally and parenterally to treat health problems.
  • Advice and treatment of any kind not currently and generally accepted and not considered appropriate by the consensus of the medical profession.

Please make sure that both your OHIP number and mailing address are correct.

The method of payment is cheque, cash or debit. If payment is by cheque, it is payable to Preventimed. PAYMENT IS DUE AT THE TIME OF THE VISIT. Prices are subject to change without notice.

The following costs are COVERED BY OHIP:

Annual Health Exam: $77.20

General Assessment: $77.20

Intermediate Assessment: $38.15

Minor Assessment: $21.70

Counseling 1/2 hour or major part of administrative services: $62.75

Clinic Procedures

Venepuncture

Adult: $3.54

Child (ages 2 – 15): $7.35

Infant (under 2 years): $9.90

Reminders and Missed Appointments

Two business days before your visit, the receptionist will phone with a reminder for booked appointment. Please reply to her message. However any cancellations require two business days notice otherwise a charge of $70.00 is applied as for a missed appointment (no show).

Administrative Uninsured Services

It is unlawful for any physician to charge or accept payment for rendering an insured service in excess of the amount payable under the Ontario Health Insurance Plan (OHIP). However, there are a number of services that are not insured by OHIP that might be adjuncts to insured medical services and are administrative in nature.

These uninsured services may be billed directly to you.

As part of your good medical care, is expected that you will be provided from time to time with uninsured services. The following is the cost of each uninsured service that a doctor is professionally obligated to tell you.

A list of these services and their corresponding costs are as follows:

COPYING/ TRANSMISSION OF MEDICAL RECORDS (WHEN NOT MEDICALLY NECESSARY), SUM OF

  • Copying – $35 (first 20 pages) + $0.30 per page thereafter
  • Out-of-pocket disbursements (where applicable) – at cost
  • Physician review of records – Physician’s hourly rate

COMPLETION OF UNINSURED REPORT FORMS

  • Schools/Camps – $27.40
  • Admission to daycare, preschool, university (including out of province and international universities) or any other educational institutions – $27.40
  • Hospital/Nursing Home Employees – $36.60
  • Back to Work Notes/Sick Notes – $18.85
  • Certificate of freedom from communicable disease – $18.85

LICENSING FORMS/CERTIFICATES

  • Driver’s Medical Examination – $56.05
  • Civil Aviation Medical Examination Report 26-0010E(001004) – Physician’s hourly rate
  • Pilot’s License Validation 26-0055(01-91) – Physician’s hourly rate

STATUTORY ACCIDENT BENEFITS SCHEDULE CLAIM FORM

  • Disability Certificate (OCF-3) – $139.90
  • Treatment Plan (OCF-18) – $139.90
  • Determination of Catastrophic Impairment (OCF-19) – $114.80
  • Treatment Confirmation (OCF-23) – $138.80

INSURANCE FORMS

  • Travel Cancellation Insurance Form – $37.45
  • Life Insurance Death Certificate – $46.70
  • Medical Certificate for Employment Insurance Compassionate Care Benefit – $53.10

LIFE AND HEALTH INSURANCE REPORT AND ASSESSMENT FEES

  • Attending Physician’s Statement – $139.85
  • System-Specific or Disease Specific Questionnaire – $93.20
  • System-Specific Examination – $111.95
  • Insurance Medical Examination – $228.35

OTHER FORMS/CERTIFICATES

  • Revenue Canada, Federal Disability Tax Credit – $46.70
  • Children’s Aid Society (CAS) Application for Prospective Foster Parent – $56.05

ADMINISTRATIVE CHARGES

  • Missed Appointment – $70.00
  • Uninsured Telephone Medical Advice – $250.00/hour
  • Prescription Renewal Without a Visit – $20.00