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Uninsured Services and Fees
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Services Not Covered By OHIP

Yorkdale Medical Clinic and your Family Doctors are committed to provide you with the best medical care, promptly and in a pleasant and professional environment. However, there are services that you may request from your doctor that are not considered medically necessary by Ontario Health Insurance Plan (OHIP) and are therefore not paid by OHIP. These services, such as: insurance forms, legal letters, sick notes, cosmetic medical procedures, etc., are called “non-insured or uninsured services”. Your doctor at Yorkdale Medical Clinic will charge for uninsured services in accordance with the fees guidelines set by the Ontario Medical Association (OMA) and the College of Physicians and Surgeons of Ontario (CPSO).

The folowing list accounts for most commonly requested uninsured services. However, if the service you request is not on the list below, please communicate it to the clinic's staff or your doctor and you will be given further clarification.

All uninsured services must be paid in full when rendered. A receipt will be provided upon settlement of the account. Please be advised that, currently, our office only accepts cash for these services.

MEDICAL EXAMS

    

Basic Visit (no or invalid OHIP) weekdays

  

$65.00

Basic Visit (no or invalid OHIP) evenings or holidays

 

$85.00

Driver's medical examination (form not included)

 

$100.00

Travel Advice

 

$35.00

Child Annual/Camp Physical

   

$70.00

Major Visit/Adult Physical

   

$120.00

Physical Examination Required by Third Party

 

$120.00

      

FORMS/NOTES

   

Sick Note

   

$25.00

Back-to-Work Note

   

$25.00

Massage Therapy, Orthotics, Physio, Compressing Stockings, etc.

   

$25.00

Day Care Note (Free of Communicable Disease)

   

$25.00

School, Camp Physical (Form only)

   

$45.00

Driver's Medical Exam (MOT, FLRC80 Form Completion only)

  

$45.00

Driver's Medical Exam (MOT, FLRC80 Form + Physical)

   

$145.00

EI Disability/Maternity Report

   

$25.00

Pre-Employment Certificate of Fitness

   

$40.00

Medical Report-Canadian Immigrants

  

$100.00

CPP Disability Medical Report Form

   

$110.00

Revenue Canada/Federal Disability Tax Credit

   

$50.00

Private Insurance Sickness and Disability – Short Term

  

$60.00

Private Insurance Sickness and Disability – Long Term

   

$90.00

Lost Prescriptions / Referral Notes

   

$20.00

Prescription by Fax / Phone

   

$20.00

Jury Duty Letter

   

$25.00

Ontario Accessible Parking Permit (For People with Disability)

   

$25.00

Travel Cancellation Form

   

$45.00

Fitness Club Form

   

$45.00

Letter on Behalf of Patient

   

$50.00 - $300.00

System or Disease Specific Questionnaire

   

$70.00

General Questionnaire

   

$30.00

Certificate of Medical Status

   

$25.00

Children’s Aid Society Application for Prospective Foster Parent

   

$55.00

Employment Insurance  - Maternity Certificate

   

$25.00

Attending Physician’s Statement

   

$125.00

Life Insurance Death Certificate

   

$55.00

Medical Certificate for EI Compassionate Care Benefits

   

$45.00

Treatment Plan Form

   

$100.00

Other Insurance Forms

   

OMA Guidelines

Clarification Report

   

OMA Guidelines

Full Narrative Report

   

OMA Guidelines

Lawyer's Letters

   

OMA Guidelines

    

IMMUNIZATIONS

    

Injections needed for Travel

$15.00

(HEP A, HEP B, Twinrix, HPV/Gardisil, Menactra,Zostavax/Shingles,Thyphrix,Avaxim)

      

TB Mantoux One Step Test  

 

$50.00

TB Mantoux Two Step Test  

 

$70.00

    

PROCEDURES

    

Wart-cryotherapy (first wart)

  

$25.00

Each additional  wart

   

$10.00

Seborrheic Keratosis

  

$40.00

Skin Tags Removal and other cosmetic procedures

   

$50.00

Excision & Suture of Moles, Cysts, Lipomas (first lesion)

  

$80.00

Each additional

  

$30.00

  

OFFICE/ADMINISTRATIVE

  

Missed Appointment without 24h notice

  

$50.00

Missed Physical Examination

   

$80.00

Transfer of Medical Records

   

First 1-5 pages

   

$30.00

Each Page After 5

   

$1.00

Prescription Renewal by Fax (when Appropriate)

  

$20.00

Notes: 

  1. Disability tax credit form - Filling the form does not ensure qualification for the program
  2. Prescription renewals will be provided by Fax or Phone only when appropirate and at the request of the patient or patient representative only
  3. Fees for Letters on behalf of the paient will be provided when appropriate and the fee depends on the work required

    Uninsured Services Clarification:

  1. Prescription renewals are uninsured when requested by a non-rostered patient, and are not associated with an insured service, and no other insured service is provided 
  2. Forms and certificates are uninsured when they are provided at the request of the patient and are transmitted to a third party such as an employer, private insurer, and others
  3. TB skin test is uninsured when requested by the patient and/or is not medically necessary
  4. Faxing & photocopying is uninsured when it is provided for the patient’s personal use or for a third party
  5. Transfer of medical records is uninsured when it is at the request of the patient.Referral notes are uninsured when the note is requested by the patient to obtain services that are not medically necessary
  6. Removal or treatment of warts is insured by OHIP only for plantar warts, genital warts and all warts in immunocompromised patients

Yorkdale Medical Clinic, 11685 Yonge St., Unit A103, Richmond Hill, ON L4E 0K7
T: (905) 770-9057 F: (905) 917-0215