Fee Schedule for Jaconello Wellness Centre
PAYMENT FOR SERVICE
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 and treatment of mold toxicity.
- 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 with heavy metal chelation.
- 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.
Clinic Procedures covered by OHIP
Child (ages 2 – 15): $7.35
Infant (under 2 years): $9.90
Two business days before your visit, the receptionist will phone with a reminder for a booked appointment. Please reply to her message.
The patient/client is ALWAYS responsible to call 48 hours prior to the scheduled appointment time to reschedule or cancel.
Late cancellation charges and Missed Appointments (no show)
If you are not able to make your appointment as scheduled, your doctor or practitioner needs to know in advance so that other patients who are
waiting for an appointment can be contacted.
If a late cancellation/rescheduling made within the 48-hour period (less than two business days notice is given) the following charges are applied:
- $150 for a new patient/client visit
- $75 for a follow-up visit
If you missed an appointment (didn’t show up) without any notice, the full appointment fee will be charged to you. It will depend on who an appointment was with as our practitioners and doctors have different fees.
Administrative Uninsured Services
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
- 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
- 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
- Revenue Canada, Federal Disability Tax Credit – $46.70
- Children’s Aid Society (CAS) Application for Prospective Foster Parent – $56.05
- Missed Appointment – Physician’s hourly rate
- Late cancellation/rescheduling made within the 48-hour period (less than two business days notice is given) – $150 for a new patient/client visit, $75 for a follow-up visit
- Uninsured Telephone Medical Advice – $250.00/hour
- Prescription Renewal Without a Visit – $20.00