FEES FOR UNINSURED SERVICES

Dear patient,

For your information, OHIP does not pay for all services that you request from your physician(s). Services that OHIP does not pay for are called “uninsured services” and it is illegal and fraudulent for physicians to bill OHIP for them. Effective May 1, 2020, this office will implement an Uninsured Services Program.

Every effort has been made to account for most of the commonly requested uninsured services in the attached information sheet. If the uninsured service you are requesting is not listed, please communicate this to office staff for further clarification.

The fees contained in the attached list are in accordance with the 2023 edition of the OMA Physician’s Guide to Uninsured Services.

All uninsured services must be paid in full when rendered; office staff will provide a receipt upon settlement of your account. Should you be unable to pay for the uninsured service at the time it is provided, please let my office staff know when and how you intend to settle your outstanding account. We will make every effort possible to assist you in the settlement of your outstanding account. Please note that our office accepts Credit card, debit or cash payments.

Should you have any further questions, please contact my receptionist, Lyn at 905-338-3937 or email us at office@DanielEyeClinic.ca

FEES

Dear patient,

MISSED VISITS

Missed Initial consult without cancellation (48 hours) $90

Missed Humphrey visual field $50

Missed OCT $40

Missed follow up appointment (Less than 48h notice) $50

Patients without a valid health card $90 +testing costs if any

Non Canadian citizen $TBD by physician

FORMS

Work note $22

Sick note $22

Insurance/employer’s report forms $60-300

MEDICAL CHART COPY

$35 for first 20 pages and $0.25 for every page thereafter

PROCEDURES

Chalazion incision and drainage $300

Excision of benign/cosmetic lesions on lid $300

Two or more lesions $350

Lens Biometry for Cataract BOTH eyes $500

Completion of Licensing Forms/Certificates:

Drivers Medical Examination $60

Civil Aviation Medical Examination Report 26-0010E(001004) Physician’s hourly rate

Pilots License Validation 26-0055(01-91) physician’s hourly rate

#OCF-3 Disability Certificate $145

#OCF-18 Treatment Plan $145

#OCF-19 Determination of Catastrophic Impairment $120

#OCF-23 Treatment Confirmation $145

Life/Health Insurance Reports

Attending Physician’s Statement. $160

Insurance Medical Examination $235

System-Specific Examination $115

System-Specific or Disease Specific Questionnaire $100

Clarification Report $388.15/hr

Full Narrative Report $388.15/hr hourly rate

Independent Medical Examination Independent consideration

Travel Cancellation Insurance Form $40