By discipline: Occupational Therapy

Practice Standards
Fee Schedule

To apply for accreditation with us, read the guidelines and standards of care, and then complete the Accreditation Request – Primary Level Services form. Print a copy, sign it and fax it to us with the documents listed below. You will receive your accreditation package in the mail.

Qualifications and Licensing
Your request for accreditation must include the following documentation:

  • Evidence of your educational credentials.
  • Evidence of current registration with your professional association.

Note: We cannot consider incomplete applications.

Accreditation is non-transferable
You must apply for re-accreditation anytime you move or add clinics to your practice. We will accredit you for work in all the clinics you list on your application. However, you must submit a separate accreditation request if you add a clinic to your portfolio or if a clinic changes location. We cannot issue payment for care at a clinic where the provider is not accredited on the day that care is provided.

Occupational Therapists must be authorized to treat WCB customers. Authorization consists of:

  • Referral by a licensed practitioner (physician, chiropractor or physiotherapist) who identifies the medical limitations and goals and objectives of treatment, AND
  • A signed Primary Authorization to Treat form from the customer’s Case Manager:
    • If this approval is not received prior to treatment, we may not pay for services provided.
    • If a claim is subsequently denied following approval for treatment, we will be responsible for payment for services to that date.
Physiotherapists billing form (PHYS)

Bill the WCB directly for services provided. To direct bill, you or your clinic requires a WCB billing number, which will be issued to you once your accreditation application has been approved. The WCB will not pay for treatment provided prior to your accreditation date or for treatment provided at a clinic for which you have not been accredited.

You are responsible for confirming in advance that the WCB will fund treatment for a customer according to the standards of care for your profession. Do not rely on the customer for this information because they may confuse their receipt of a claim number with a commitment by us to pay for their treatment.

  • Summarize all services provided during the billing period using the Physiotherapists billing form (PHYS).
  • Follow the fee schedule agreed to your professional association and the WCB;
  • Payment can only be issued if the invoice meets the criteria. The following information is required:
    • Worker’s name
    • Worker’s address
    • Provincial health number
    • Date of birth
    • Billing period*
    • Care provider number
    • Clinic number
    • Occupational therapist’s name
    • Occupational therapist’s address
    • Occupational therapist’s phone and fax number
    • Fee code(s)
    • Fee code amount
    • Number of units
    • * Follow the guidelines for the billing period
      • Monthly
        • 1st of the month to the end of the month (i.e. Jan. 1 – Jan. 31/18)
      • Bi-Monthly
        • 1st of the month to the 15th of the month (i.e. Jan. 1 – Jan. 15/18)
        • 16th of the month to end of the month (i.e. Jan. 16 – Jan. 31/18)
        • Always use 1st of the month regardless of holidays and weekends.
        • Please maintain consistency with the method you choose.
        • If the primary start date is within the billing period, then the beginning of the billing period should be the primary start date.
          • i.e. Primary start date is Mar. 3/18, billing period is then Mar. 3/18 to Mar. 16/18, or Mar. 3/18 to Mar. 31/18, depending upon the billing period chosen from the above examples.

The WCB will not pay any account rendered by a physician, surgeon, hospital or other health care professional or institution for medical aid service if application for payment is received by the WCB after a twelve-month period from the time the medical aid is administered to an injured worker. See Procedure PRO53/2006.

Retain your daily record of the service you provide to our customers in case an audit is required.

If you have submitted an invoice that does not have the correct amount of units (too many/not enough), in this case an adjustment/addition needs to be made to your original invoice.

How to make an adjustment/addition to an invoice:

Write Adjustment/Addition on the top right hand corner of your invoice.

Adjustment (Amending a fee code that has already been paid)

To make an adjustment to a fee code that was already paid, the WCB needs to reverse the number of units you indicated on the original invoice, then reissue the correct amount of units. To do this:

  1. Print off original invoice that needs adjusting.
  2. Bracket the fee code, number of units and extended total for each line you want reversed.
  3. To show your adjustment: At the bottom of your invoice, indicate the fee code, the new number of units, and the new total for each fee code you want paid.
  4. Provide the new invoice total.

See Billing adjustment example.

Addition (For a fee code that has not been billed on your original bill)

  1. Print off original invoice that needs adjusting.
  2. To show your addition: At the bottom of your invoice, indicate the new fee code, the number of units, and the new total you want paid.
  3. Provide the new invoice total.

If you use WCB Online Services to retrieve your original invoice:

  1. Login to your WCB Online Services account.
  2. Click on Medical Invoices.
  3. Click on Review Forms.
  4. Find the form you need to adjust.
  5. Click on the edit icon.
  6. Worker information will be displayed, scroll to bottom and click ‘Next.’
  7. Invoice details will be displayed, scroll to bottom and click ‘Next.’
  8. Injury details will be displayed, scroll to bottom, click ‘Review.’
  9. Your invoice will appear.
  10. Print.
  11. Follow the instructions above to manually make adjustments/additions.

Submit to the WCB by emailing or fax 1.888.844.7773.

Accreditation with us requires that you:

  • Comply with the standards of care and fee schedule established for your professional group;
  • Demonstrate ethical practice standards on a day-to-day basis, including disclosure to any perspective WCB customer of any business relationship you may have with their employer. This allows the worker to make an informed decision regarding their choice of care provider;
  • Refrain from using your affiliation with the WCB in any advertising of your services.

Under legislation, care providers do not require a signed release from an injured worker in order to provide medical information to us because:

  • Our staff requires customers’ medical records to process claims and appeals.
  • We may provide copies of reports to other health care providers to assist in obtaining the best possible assessments and treatments for injured workers.
  • In the case of an appeal, a worker’s records may be made available to an employer or others, but only with the worker’s approval.

The OT forms are coded forms are to be used to provide information about treatment, functional recovery, and response to treatment.

Please complete the OT reports legibly and fax them to us as quickly as possible.

You are encouraged to register for a secure @WCB Online Services account, which will allow you to view past and present payment vouchers.

We issue payment to care providers weekly and provide vouchers to confirm that the payments that were issued. These vouchers may include explanatory codes to provide detail regarding specific services.

Submit a Direct Deposit Application to receive your payment by electronic transfer.

Health care providers, like employers and workers, are required to report any injury that requires medical attention, whether or not the worker needs time off work beyond the day of the injury.