Physical therapists must apply for accreditation with the WCB. Learn about accreditation, authorization to treat, billing, payments, reporting to the WCB and what forms you need.
Before you can provide services to WCB customers and bill the WCB directly for those services, you must be accredited by the WCB.
To apply for accreditation with the WCB:
- Read the WCB Physical Therapy Practice Standards.
- Complete, print and sign the Accreditation Request – Primary Level Services form.
- Attach copies of your educational credentials.
- Attach copies of current licensure with your licensing body.
- Attach copies of additional educational credentials if you are applying for aerobic assessment and treatment accreditation.
- Fax your accreditation package to the WCB’s health care services department to the fax number on the form.
Make sure all documentation is included and fax it to the WCB. Note: The WCB cannot process incomplete applications.
Our health care services department will review your application after receiving it. We will:
- Review your credentials against the requirements listed in the WCB Physical Therapy Practice Standards.
- Add your name to the WCB’s approved providers list, if you are eligible.
- Notify you by mail that your accreditation request has been accepted or denied.
- Mail your WCB billing number to you.
Accreditation is non-transferable
You can only bill for services from all the clinics you listed on your application. If you want to add a clinic to your portfolio or if a clinic changes location, you must submit a separate accreditation request for that clinic before you begin treating customers there. We cannot issue payment for care at a clinic where the provider is not accredited prior to that care being provided.
Your physiotherapy license includes a direct access provision, which means you can treat customers without referral by a licensed provider.
However, within three days of commencing treatment, you need to send a Physiotherapist’s Initial Report (PTI) form to the WCB detailing your initial findings. We will contact you if funding cannot be granted and will pay for services to the date of that advice. See the PTI User Manual.
To prevent financial hardship to a WCB customer, bill the WCB directly for approved services. To direct bill, you will need the WCB billing number you or your clinic received when your accreditation application was 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 we will fund treatment for a customer by submitting a Physiotherapist’s Initial Report (PTI) to the WCB according to the standards of care for your profession. Unless the WCB discontinues funding, you may treat up to 10 sessions.
Summarize all services provided during the billing period using the Physiotherapist’s Billing (PHYS) form.
Follow the fee schedule agreed to by your professional association.
Forward the completed Physiotherapist’s Billing (PHYS) form to the WCB.
Payment can only be issued if the invoice meets our criteria. The following information is required:
- worker’s name
- worker’s address
- Provincial Health Number (PHN)
- date of birth
- billing period*
- care provider number
- clinic number
- physical therapist’s name
- physical therapist’s address
- physical therapist’s phone and fax number
- fee code(s)
- fee code amount(s)
- number of units
* Follow the guidelines for the billing period:
- 1st of the month to the end of the month (i.e. Jan. 1 – Jan. 31/20)
- 1st of the month to the 15th of the month (i.e. Jan. 1 – Jan. 15/20)
- 16th of the month to end of the month (i.e. Jan. 16 – Jan. 31/20)
- 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 March 3/20, billing period is then March 3/20 to March 15/20, or March 3/20 to March 31/20, depending upon the billing period chosen from the above examples.
If the WCB receives an application for payment after a 12-month period from the time the medical aid is provided to an injured worker, the WCB will not pay any account rendered by a physician, surgeon, hospital or other health care professional or institution. See WCB procedure, Medical Aid Billings – Payment (PRO 53/2006).
Keep a 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:
- Print off the original invoice that you need to adjust.
- Bracket the fee code, number of units and extended total for each line you want reversed.
- 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.
- Provide the new invoice total.
See a billing adjustment example.
Addition (for a fee code that has not been billed on your original bill)
- Print off the original invoice that you need to adjust.
- 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.
- Provide the new invoice total.
If you use your WCB online account, to retrieve your original invoice:
- Log in to your WCB online account.
- Click on “Review submitted invoices”.
- Find the form you need to adjust.
- Click the “Action” icon to view the PDF invoice.
- Your invoice will appear.
- Follow the instructions above to manually make adjustments/additions.
To ensure that WCB Practice Standards for Care for Physical Therapists are being followed, compliance surveys may be conducted. Treatment centres, clinics and individual practitioners will be notified two weeks before they are to be surveyed and can prepare for the survey by reviewing the survey form and guidelines in advance. Surveys take approximately 1.5 hours and will be conducted by WCB representatives.
When an injury claim has been disallowed or benefits terminated, physical therapists will be notified that the WCB cannot pay for further assessment or treatment. We will only pay for treatment for which authorization was given to the date of notice of termination. We will also pay reporting fees to the date of notice.
The WCB issues payments to care providers weekly and provides statements to confirm the payments were issued. These statements may include explanatory codes to provide details regarding specific services.
Care providers, like employers and workers, are required to report to the WCB any work-related injury that requires medical attention, whether or not the worker needs time off work beyond the day of the injury. Prompt reporting allows the WCB to arrange timely payment of benefits to injured workers.
Under provincial legislation, care providers do not require a signed release from an injured worker in order to provide medical information to the WCB because:
- WCB staff require customers’ medical records to process claims and appeals.
- The WCB may need to provide copies of reports to other care providers, such as assessment teams, treatment centres and specialists, 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.
Use the following forms to provide information about treatment, functional recovery, and response to treatment. Please fill out reports completely and legibly and fax them to the WCB as quickly as possible. We cannot pay for illegible or incomplete reports.
- Functional Outcome Measures (FOM)
Administer the appropriate Functional Outcome Measures self-report tests to WCB customers as soon as possible to help identify those who may be at risk for prolonged recovery and who would benefit from more intensive treatment. These tests include:
Only the customer’s FOM score should be submitted to the WCB, not the form itself. The score is to be reported on the Physiotherapist’s Initial Report below.
- Physiotherapist’s Initial Report
You are required to submit a Physiotherapist’s Initial Report (PTI), including the appropriate FOM score, for all injuries, including those that do not result in time off work. Where the injured worker loses time from work because of an injury, the PTI provides confirmation of disability, which allows the WCB to arrange timely payment of benefits to injured workers. Prompt reporting is important to prevent financial hardship for the injured worker and family. See PTI User Manual.
- Physiotherapist’s Progress/Discharge Report
A Physiotherapist’s Progress/Discharge Report (PTP), including the appropriate FOM score, should be completed after each block of 10 treatments unless the worker has been discharged, in which case, the PTP should be completed within seven days. See PTP User Manual.
- Practitioner’s Return-to-work Report
Once a return-to-work plan has been agreed upon, the physiotherapist will submit a Practitioner’s Return-to-Work Report (PRTW) to the WCB with copies to the primary care provider, the employer and worker to confirm the hours of worker and restrictions.
- Other reports
Copies of special reports – diagnostic, operative, and so on – should always be forwarded to the WCB. They provide us with relevant information and save the attending practitioner from preparing a separate report.
Physiotherapists report after every 10 treatments using the forms listed above. Failure to report can seriously delay an injured worker’s claims process and may result in delays or non-payment to the provider.
The WCB pays reporting fees when the care provider invoices the appropriate fee. If more than one report is received in the same day, only one report fee is paid.
There is a two-tier fee for PTI and PTP reports: one for reports that include FOM scores and a lower fee for those that do not include the scores.
View reports (WCB’s secure online site)
The WCB has a “View client information” application available for primary level chiropractors and physical therapists to use through their WCB online account. This application provides you with the ability to easily view medical documents online for an injured worker that you are treating. As soon as a new report comes in for your claim, you will automatically be able to view it.
The “View client information” application will allow you to see medical reports from other care providers, as well as referrals the WCB is making to specialists, diagnostics, assessment teams, etc. Assessment team reports do not appear on the “View client information” application as the assessment team will send a copy of the summary report to all current providers and a copy of the complete report to the primary care provider and surgeon.
You must have a WCB online account to view medical documents online for injured workers you are treating. You must have an online report submitted before the “View client information” application will be available to you. You also must complete online reporting regularly to use “View client information”.
For soft tissue injuries, refer to the Primary Chiropractic and Physical Therapy Soft Tissue Treatment Guidelines.
Return to work should generally be part of each worker’s treatment plan. For more information, see our recovery and return to work page.
When treating WCB customers, care providers assume certain roles and responsibilities. The WCB relies on all care providers to ensure that:
- All work-related injuries requiring medical aid are reported promptly.
- All treatment is necessary and consistent with established agreements.
- All invoices accurately reflect the services provided.
- The employer and worker are aware of current restrictions to allow early return to work.
When treating WCB customers, physical therapists will:
- Know and follow all requirements of the WCB’s Physical Therapy Practice Standards.
- Refer to the Support Package for Chiropractors/Physical Therapists.
- Bill the WCB in accordance with the fee schedule established by the WCB with your professional group and all requirements of your licensing body.
- Show ethical practice standards on a day-to-day basis. This includes informing any prospective WCB customer of business relationships you may have with their employer, so the worker can decide whether they want to choose you as a care provider.
- Avoid mentioning in either your clinic’s advertisements or personal advertisements that you treat WCB customers or you are affiliated with the WCB in any way.