A MODERN PERSPECTIVE
A MODERN PERSPECTIVE
A MODERN PERSPECTIVE
non-INSURED FEES
Clinic Policy 2021
Non-Insured Services and Procedures
You will be billed for some services and procedures that are not covered by the Ontario Health Insurance Plan. A list of the non-insured services and corresponding fees may be found below.
Fees for Non-Insured Services and Procedures
These fees are subject to change without notice. Physicians reserve the right not to charge for certain items based on individual circumstances.
Currently, we are limited to accepting payments by cash or cheque.
Visits and Procedures
SERVICE
Complete Exam
Intermediate Exam
Minor Exam
TB (injection + interpretation)
TB (2step)
TB (injection only)
Immunization (injection only)
Cortisone (infusion)
Liquid Nitrogen (one application)
Liquid Nitrogen (multiple applications)
Other Exams
FEE
$176.78
$77.20
$50.00
$35.00
$50.00
$25.00
$15.00
$25.00
$30.00
$45.00
Variable
Office Procedures
SERVICE
Not Requiring Sutures
1 to 3 Lesions
Cyst, Lipoma, Biopsy Excision with Sutures
FEE
$35
$45
$75
Missed Appointments
SERVICE
Complete
(30 minutes)
Follow-up
(15 minutes)
FEE
$40
$20
Chart Transfers
SERVICE
Chart Transfer (Individual) Review
Chart Transfer (Family) Review
FEE
$40
$60
Administrative Fees
SERVICE
Paper copies 1 to 20 pages
Paper copies 21+ pages
Disk fee
Postage/Courier
Retrieval from Archive
FEE
$30
$0.25 per additional page
$40
Variable
Variable
Other Services
SERVICE
Prescription Renewal (by fax or telephone)
Lost Requisition
FEE
$20
(no charge if patient is 80+)
$10
Third Party Forms
SERVICE
School /
Summer Camp
Admission (daycare/school/ graduate studies)
Wellness Certificate (fitness to work)
Employees (hospital/nursing home)
Daycare (disease-free)
Maternity Certificate
Employer Forms (other)
FEE
$30
$30
$40.25
$40.25
$21
$20
$35
* examination fees not included
Third Party Visits
SERVICE
Driver's licence (includes complete exam, urinalysis and form)
Attending Physician's Statement
Insurance Certificate OCF-18
Insurance Certificate OCF-3
Insurance Certificate OCF-23
Insurance Certificate OCF-19
System or Disease Specific Questionnaire
Medical Evaluation for Insurance Purposes (includes complete exam)
Trip Cancellation
Death Certificate (for life insurance)
Compassionate
Care Certificate
FEE
$150
$153
$153
$153
$152
$126
$102
$249
$41
$51
$59
Government Forms
SERVICE
Federal Disability Tax Credit
CPP Disability Medical Report (up to $85 paid by government)
CPP Narrative Report (up to $150 paid by government)
CPP Request for Reassessment
Citizen and Immigration
Request for Medical Information (Application to Armed Forces)
Central Collection Service (Request for Physician's Information)
FEE
$79
$125
$150
$25
$125
$100
$125
Other Services
SERVICE
Application for Foster Parents / Adoption (CAS)
Medical Certificate for Employment Insurance Sickness Benefits (INS5140)
FEE
$62
$42
Sick Notes
SERVICE
With Appointment
Without Appointment
FEE
$21
$27
Hourly Rate
SERVICE
Our Physician Hourly Rate
FEE
$175 to $250