Salveo Family Medicine Clinic

Uninsured Services          January 2010        Salveo Home

The Alberta Health Care Insurance Plan pays for many of the services patients receive from their doctor.  However, a number of services are not covered by the government plan.  These are uninsured services.  Some are billed to lawyers, government agencies or others.  Some are billed to the patient.

The patient of a third party such as your employer, insurance company or school may request a letter, report, form, etc., from your physician.  In addition to office materials, these services require the time and expertise of your doctor and staff.  As a result, you or the third party will be billed a fee to cover these costs.

In general, the service requested will not be provided until payment is received in full, whether that be cash, cheque, debit or credit card.  Inquiries can be directed to the Front Desk.

Note: Fees subject to change without notice

Appointment Fees (Includes Invalid AHC & Late No Show)

  • 10min $50

  • 20min $100

  • 30min $150

  • Uninsured Forms or Letters

  • Private letters/forms (eg. Sick notes)                    $35

  • Insurance forms (eg Disability)                             $45-260

  • Blue Cross Special Authorization                           $35

  • Third party letters/examination                            Fee based on time/complexity

  • Pregnancy Leave and Employment Insurance            $40-70

  • AADAC application for Admission                          $90

  • Other Forms not specified                                     Fee Based on time/complexity

  • Pre-employment Medical Examination and report     $110-250

  • Certificate of fitness (for school, summer camps, daycare, air travel etc)      $35 minimum

  •  

    Transfer of Records to Another Medical Provider As Requested by the Patient

  • Minimum $50/chart, additional fee based on time & complexity of request

  • Uninsured Motor Vehicle Related Forms

  • Disabled Parking Authorization                    $50-70

  • Driver’s Medical for those <74.5y, regardless of whether they are receiving a Routine physical at the same visit     $115-210

  • MVA Insurance forms:

  • AB-1a          $75

  • AB-2           $125

  • AB-3           $100

  • AB-4           $100

  • AB-5           $125

  •  

    Uninsured Procedures

  • Certain Uninsured procedures - Cost as appropriate to procedure

  • Uninsured vaccinations and injections (for example Gardasil, Twinrix, Havrix)    $30 per injection

  • Travel Vaccination Counselling                 $100 per person per visit

  • Telephone Prescription Uninsured Service

  • Telephone Prescription Refills        $50

  • Advice by phone                            $80 per 15 minutes

  • Uninsured Office Visits (no Alberta Health Care or Quebec Health care)

  • 1st Visit             $150

  • Full CPx             $200

  • Reg Visit            $100

  • Pelvic exam with pap smear        Additional $50

  • Costs of Uninsured Supplies Paid to Clinic

  • Costs as appropriate to supplies utilized

  • Liquid nitrogen to non-plantar warts or skin lesions $40-70

  • Drugs including vaccines, cortisone injections, ointments, medications including, but not limited to, topical or injectable medications including local anesthetics

  • Dressings for major wounds

  • Intra-uterine contraceptive devices

  • Long Distance phone charges

  •  

    Salveo Home