Many of us have a trusted, local pharmacy or a dentist we’ve known for years. It’s worth the time you spend finding the right practitioner for you.
In addition to your traditional visits to the dentist or going to the pharmacy, your employee group plan also has you covered for paramedical service providers who focus on your well-being.
Paramedical services include physiotherapists, chiropractors, massage therapists, podiatrists, psychologists, and others. To get the best care out of these paramedical services, here are tips for finding a service provider who is focused on you getting better and helps you stay on track towards wellness.
Tip #1: Ask your provider if what they are recommending is medically necessary.
The practitioner is the expert on reducing physical or mental stress, mitigating pain, and improving your health and/or mental wellness. You know your body and how you feel. Asking questions about your treatment plan and advocating for yourself will ensure the practitioner is clear about what they’re doing to help you get better and why. Ask your practitioner how they will track your progress.
Some service providers may be suggesting additional services to maximize how much you spend in their office, rather than what’s medically necessary to get you better. Speak to your family doctor if you’re not seeing improvements in your condition.
Tip #2: Research their professional credentials and check the delisted provider list.
Check that your practitioner is accredited by a Canadian or international professional organization (in the place where the service is provided) and they display the certificates, licences and trainings that they’ve completed on their website and/or in their office.
Remember to check your benefits booklet. It includes information on which accreditations a provider needs to have for their products and/or services to be covered by your benefits plan. Your plan terms and coverage details are updated on a regular basis to reflect any changes or updates to your plan.
Avoid surprises when the bill comes: Check if a provider/supplier is on the delisted providers list. Claims will not be approved or eligible for reimbursement from these providers.
Tip #3: Ask your practitioner for estimates for expensive products and services.
Your health and wellness are important investments - just like the purchase of a vehicle or a home – so shop around to find the right choice for you.
We recommend getting an estimate for any product or service you would find difficult to pay out-of-pocket. Learn how.
You can also check your benefits booklet or contact OTIP Benefits Services to check if it’s covered under your benefits plan, if a doctor’s referral is needed (e.g. massage therapist) and the maximum amount covered for each benefit year.
Avoid surprises when the bill comes: Check the reasonable and customary (R&C) limits for the services you are using. R&C limits are the maximum you can be reimbursed on a particular service or item, which you can check online.
Tip #4: Check that your provider is following good business practices.
When working with your provider we recommend you:
Check your receipts to make sure you’re getting charged for what you paid for.
Ask ‘why’ if you’re asked to give a signed claim form – it’s like giving a practitioner a blank cheque, which isn’t something that you normally would do.
Use your benefits plan for your health and wellness, and most importantly, use it well. We all can do our part to protect the plan, keeping it sustainable so can you access coverage today and well into the future.