Alberta Health Services
Alberta Health provides a funding cap to Parkland Rehabilitation for physical therapy treatments. Your initial assessment will be covered by Alberta Health Services. Your physical therapist will assign you a determination of need score (at the time of your initial assessment) which will determine your eligibility for funded treatment. Alberta Health Services has given the physical therapist guidelines to determine whether or not you qualify for funding. If you rate a 7 or above you will have another 2 visits covered by Alberta Health Services. If you rate 6 or below you will be asked to pay privately or access your personal benefits after your initial assessment.
If you have had surgery and are assessed by a physical therapist within 56 days from the time of your surgery you may qualify for 7 visits. (1 initial assessment / treatment and 6 additional treatments)
If you have had a fracture and have had the area in a cast/sling/tensor (some type of immobilization device) and you are assessed by a physical therapist within 14 days of having the immobilization device removed you may qualify for 7 visits. (1 initial assessment / treatment and 6 additional treatments)
Patients who have central neurological injuries are covered under a separate funding cap and may receive up to seven visits dependant on the severity of the presenting problem.
Patients who are considered to have a low income may qualify for 7 funded visits including the assessment. To qualify for this funding a patient must be in a government subsidy program, or be experiencing temporary financial hardship, which will be outlined for you when registering at the clinic for the assessment. For further information please refer to the Alberta Health Services website at www.capitalhealth.ca
Workers Compensation Board (WCB)
If you have been injured at work it is important that you do the following:
1. |
Inform your employer of your injury and ensure that a claim is filed with WCB. |
2. |
See your physician to clear any medical problems and so that they may send the appropriate paper work to WCB. |
3. |
See your physical therapist. A patient may come in for an assessment without a referral; however, the patient must have a Doctor's referral within five days of the assessment for claims processing. |
If a patient’s claim is not accepted patients are personally responsible for covering the cost of treatment rendered, with the exception of the cost of the original assessment. For further information please refer to the WCB website at www.wcb.ab.ca
Motor Vehicle Accidents (MVA’s)
Person’s involved in a motor vehicle accident have direct access to physical therapy services without a Physician’s referral. At the time of the accident, it is important to contact one’s insurance provider and ensure that an AB1 form is filled out. This keeps the claim open for the first 90 days from the time of the accident should the person require any treatment for injuries sustained in the MVA. At the time of assessment, the physiotherapist will be required to do an AB2 (assessment report and treatment plan) for the insurance company. Direct billing to the insurance company is provided for the majority of those injured, for treatment provided within the first 90 days following the accident. For further information please refer to the Alberta government site for fees and guideline forms at www.finance.alberta.ca
Private/Insurance
Persons with extended health care coverage should be aware of the limit of their physical therapy coverage. This is usually stated as a dollar amount or a percentage per visit.
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