HEALTH BENEFIT COVERAGE

EXTENDED HEALTH BENEFITS


For our patients needing physiotherapy and rehabilitation, many health benefit companies have set up direct billing arrangements for the convenience of all involved. Pivotal Physiotherapy has made direct billing arrangements with the health benefit companies listed below:

We also have several other health benefit companies where we can direct bill for specific plans for physiotherapy and rehabilitation, depending on your level of coverage. These companies include:

Please know that the amount of coverage you receive depends on your benefit plan and, in some cases, your injury. Here at Pivotal Physiotherapy, we are happy to help you determine the amount of coverage you’ll receive for your treatments. Please be aware that you are responsible for any treatment costs not covered by your plan.

We encourage you to invest in improving your health by taking advantage of any coverage provided by your benefit plan and also by completing prescribed treatments. At Pivotal Physiotherapy, we only prescribe treatment when it’s needed. Our main goal is to help you improve your health through physical therapy and get you back to all that moves you.

ALBERTA HEALTH SERVICES


Depending on funding availability, you may be eligible to receive physiotherapy coverage through Alberta Health Services. However, each private physiotherapy clinic is allotted a limited amount of funding each month, and we can only accept a certain number of AHS patients per day, so there may be a waiting list.

*AHS treatment coverage resets each year. The AHS year runs from April 1st to March 31 the following year.

FRACTURE/POST-SURGICAL PATIENTS


If you’ve had surgery or suffered a fracture, and are booking within the allotted date range given by AHS, then you are automatically eligible for Alberta Health Services coverage for your initial evaluation and an additional six physical therapy rehabilitation treatments. Further funding may be available for patients who are either in the lower income tax bracket or who are receiving government subsidies or financial assistance.

AUTO ACCIDENT INSURANCE


There are two protocols regarding treatment after an automotive accident: “Under Protocol” and “Outside Protocol.” To be Under Protocol, you must complete and submit an AB-1 form to your insurance company within 10 business days of the date of your accident. The AB-1 form is available at our front desk and online for download. Once you’ve submitted these forms, we’ll directly invoice your auto insurance company and your case is considered “Under Protocol.”

If you don’t submit your AB-1 forms within 10 business days, you are considered “Outside Protocol” and your automotive injury adjuster will decide whether direct billing will be authorized or if you’ll need to pay for your physiotherapy treatment and submit your receipts to your insurance company.

WORKERS COMPENSATION BOARD


If you’ve been involved in a worksite injury, and a claim has been started with WCB, you may contact our clinic and book in an initial appointment as soon as possible. Workers Compensation board will always cover the 1st initial assessment and treatment, after that your case manager will either approve or deny you for further treatments.

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