Reasonable and Customary Fees 2018 – Paramedical Services
Consistent with industry standards, IA Financial Group (Industrial Alliance Insurance and Financial Services Inc.) applies reasonable and customary limits to paramedical services. Paramedical services refer to health treatments such as massage therapy, physiotherapy, acupuncture, speech therapy, chiropractic care, etc.
We review reasonable and customary limits on a continual basis and make changes periodically to ensure that our allowed amounts are representative of the current standard fees in the market. The new reasonable and customary limits will take effect on January 1, 2018.
What are reasonable and customary fees?
The cost for a paramedical service varies from one provider to another. Reasonable and customary fees correspond to the maximum acceptable amounts established for certain services, according to their average cost in any given region.
What are the impacts on claims?
A limit applies to a claim for a paramedical service if the provider charges more than the reasonable and customary fee. The plan member must pay the difference. According to plan specifications, limits are also subject to any deductibles and reimbursement percentages.
Where to find the updated reasonable and customary fees list?
You may refer to the list in My Client Space, under Guides and Resources, in the left-hand menu.
For further information regarding your coverage with respect to reasonable and customary fees for paramedical services, please refer to your booklet or contact our Customer Service Department.
If you have any questions, please contact your advisor or your iA Financial Group Account Executive.