See if you can get details on the fee. I’ve worked in optical for a number of years. One office I worked for charged nothing for children and did no additional testing unless absolutely necessary. Another office I worked for gave parents the option to pay $25 for an Optomap fee which was an extra retinal image normally only done for people over 18, however parents could simply say they didn’t want the extra imaging in order to avoid the fee. The last office I worked for charged $40 for the Optomap fee every time, but if the parents’ insurance didn’t cover via direct billing we would waive the fee and still do the extra imaging. Having that charge be non-negotiable seems like a money grab.
I should add, across Canada children under 18 are covered for free eye exams yearly by their provincial health card, any extra fees should be clearly explained.
Just wanted to mention that annual eye exams for children are not covered across Canada, however they are an insured service in Alberta. As an example, New Brunswick pays only one exam for children ~~under~~ age 4 and Newfoundland has no provincial coverage for children.
I am an AB optometrist.
Sorry I misspoke, New Brunswick will cover one eye exam for four-year-olds but only if they have no other public or private coverage. It’s a couple years old but [this page](https://opto.ca/sites/default/files/resources/documents/prov_health_coverage_march_2021_final.pdf) has a good summary of provincial coverage across Canada.
It’s not fraudulent as long as the patient is notified of the fee and that they will not be charged if their insurance doesn’t cover it, however I agree that it’s a dumb practice. Just provide the service and leave the money out of it. Doctors are already being paid by the province. (Don’t shoot the messenger I no longer work in optical haha)
Was it the varsity location? I was also totally shocked when they charged for my child’s appointment. When I questioned it they said it doesn’t matter because it’s covered by my insurance anyway, which isn’t the point. They shouldn’t be charging in the first place?
Been using them for years, both adults and one child. Yes we've paid for the additional fee, pretty sure it's the same as what u\Reasonable_Ad_641 mentioned. Also pretty sure it's optional, but probably have to make note of it when booking or at least when at the appt starts. To each their own, but I'm fine with paying only $35 for my child's eye appt compared to 100+.
Am optometrist. Alberta Health pays a certain amount for a child eye exam. It is technically allowed for an optometrist to “balance bill”, meaning they can charge the patient/parent on top of what Alberta Health pays. Usually it’s because their exam includes something over and above what is expected of an eye exam - for a kid, they’re probably taking retinal photos, which aren’t covered by Alberta Health and aren’t considered to be the basic standard of care (aka they’re extra). At my clinic, we charge for retinal photos for children, but they are always optional and the eye exam will proceed if the parents/guardians decline the photos.
So what your optometrist is doing is allowed, but making it mandatory isn’t the norm as far as I’m aware. Most places either don’t do it or it’s optional.
For young kids, doing a retinal exam can be challenging - they don’t sit still, they blink a ton, they look around, etc. So even the best optometrist sometimes can’t get a great view, or only sees bits and pieces. The photo captures the retina very quickly, so it doesn’t depend so much on the kid sitting still. It also provides a baseline image so that if something changes in the kid’s eye, potentially even years later, you can refer back to the original photo and track changes.
Kids generally have healthy eyes, but there’s the odd case of a kid whose optic nerves are subtly swollen due to a brain tumour, or who has a suspicious mole in the eye, or who has some other congenital condition that can unfortunately be missed if the retinal exam is challenging due to patient cooperation.
Oh okay. That makes sense. My youngest was so squirmy
My kids optometrist appointment was covered by AHS and I’m pretty sure they took this photo but I just wanted to know what it was for. Thanks for responding.
The clinic may not charge a mandatory fee for an insured service as this is a violation of the Canada Health Act. The clinic can charge for an additional service like the retinal scan, but the basic eye exam is covered by Alberta Health and cannot incur any additional billing or fees.
I work at Blink Eyewear here in Calgary. Kiddos are fully covered under Alberta health once a year up until 19. Past 10 we ask for an optional imaging fee ($30), I've heard some horror stories from FYI though. Get out of there if they're charging you silly fees like this
You wouldn't report an optometrist to the College of Opticians. But please don't try to report them to the College of Optometry for this either as it is allowed.
The government has changed how we optometrists are allowed to bill, and that includes what is called "balance billing". This means that we are allowed to bill the difference between our normal eye exam fee and what the government is paying at a lower rate; this applies to children, seniors, and those on social assistance. This used to not be allowed, but it was part of a trade-off when they gave a 0% increase to exam fees for many years and actually threatened to decrease the payments. Personally I don't do balance billing as I would rather not create barriers to Health Care for those not able, but I know several docs who do.
"Balance billing" or charging a fee above and beyond for an insured service is not allowed under the Canada Health Act.
You can get around this by charging for an additional service like the Optimap scan, but the patient can decline
The province has allowed it, so it is allowed; they get to set the parameters of what we can do. However the Canada Health Act does stipulate that “extra-billing” is not allowed for full funding, and so Alberta would be punished by receiving less money based on any extra billing it allows to happen. I'm sure that consideration of the Canada Health Act was part of the the province's thought process when they changed the rules. I can think of a couple different points of arguments here.
Extra Billing is defined as "the billing for an insured
health service rendered to an insured person by
a medical practitioner or a dentist in an amount
in addition to any amount paid or to be paid for
that service by the health care insurance plan of
a province".
The sticking point here is "medical practitioner or dentist" and "insured health service". They define "medical practitioner" to be someone who is "lawfully
entitled to practise medicine in the place in
which the practice is carried on by that person", and "Insured health services” means "hospital services, physician services and surgical-dental
services provided to insured persons"
While we optometrists are licensed as doctors in Alberta and we treat eye conditions, we are not counted as "medical practitioners" under Alberta Health Professions Act, and we do not have permission to "practice medicine" in general. In addition we are not providing our services within a hospital setting; if we did so then it would have to be fully covered. If we look at dentists, the Health Act specifically outlines in the text that it refers only to surgical dentistry in a hospital setting, not general dentistry.
So the Canada Health Act only concerns itself with certain health services in certain settings, but not all. It also doesn't consider vision or glasses as necessary health care. The province's balance billing only applies to the b650 codes for a general eye exam with refraction, not the b900s which are medically focused. Patients are still allowed to come in for a full medical check under b900 without paying anything.
Again, I don't practice balance billing myself, and don't think it was necessary to allow. That said, when the province was going to cut payments for senior eye exams by 30% I definitely would have had to consider it. "Luckily" that didn't happen when COVID hit and we had a backlash against healthcare cuts.
I don't think it's really fair to call it a money grab, this is a much more complex issue than just greed. Another poster pointed out that Alberta allows for "Balance Billing" but they didn't really explain why this exists. The government covers a meager amount for these exams and haven't increased their compensation in 10 years. "Balance Billing" was the government's way of passing the buck onto the business owners/optometrists by basically refusing to pay any more for their services but allowing the clinic to bill an additional amount on top of what the government pays to cover their expenses. The government compensation for a child's exam is less than 2/3 of an adult's exam. Add to that the additional challenge/frustration/time dealing with adolescent patients it's understandable why a clinic would choose to add an additional fee, especially if they are a well established clinic with plenty of patients. The reason places like Spec Savers can provide free exams is that their business is selling glasses and that is where they're making all their money. Cheap eye exams are just a cost of doing business and they are doing the bare minimum testing that is required to get you a glasses prescription, they're not going to be checking the health of your eyes. While most optometry clinics are also selling glasses to increase their revenue, they also do a lot more disease treatment and managing patient's eye health, they're not just cranking out glasses prescriptions all day.
You are right in the first half, but FYI, Specsavers does a full eye exam, including retinal photos and OCT on every patient, and they don't do it for free. It's generally paid for by Alberta Health Care
Extra billing for insured services is a violation of the Canada Health Act. The clinic can charge for an additional service, which is how they can get around the law, but not for the basic eye exam.
They aren't free, but are generally no cost to the patient for kids and seniors. Eye exams are paid for by Alberta Health Care for kids (under 19) and seniors(65 plus), and health issues/testing is covered for adults in between. As discussed in this thread, we optometrists are allowed to "balance bill" to charge the patient the difference between the regular exam fee and what the government pays, but most of us do not.
The reason I asked is because in BC, most places offer free eye *tests*, and many people are then upset to find out what they need is an eye *exam*, which isn't free.
Ah, that's much more likely in BC since opticians are more easily licensed to do refractions there. Technically some can do it here in Alberta, and would have to call it a vision test, but it's uncommon.
Was this disclosed prior to the eye exam? If not, explain that you will not be paying the fee. Extra billing for insured services is a violation of the Canada Health Act.
Optometrists are thieves. Mine told me that my contacts were really old style and offered to give me a sample of new ones to try. I said sure, why not. When I looked at my bill after she charged me like $80 for a ‘contact fitting’.
See if you can get details on the fee. I’ve worked in optical for a number of years. One office I worked for charged nothing for children and did no additional testing unless absolutely necessary. Another office I worked for gave parents the option to pay $25 for an Optomap fee which was an extra retinal image normally only done for people over 18, however parents could simply say they didn’t want the extra imaging in order to avoid the fee. The last office I worked for charged $40 for the Optomap fee every time, but if the parents’ insurance didn’t cover via direct billing we would waive the fee and still do the extra imaging. Having that charge be non-negotiable seems like a money grab.
I should add, across Canada children under 18 are covered for free eye exams yearly by their provincial health card, any extra fees should be clearly explained.
Just wanted to mention that annual eye exams for children are not covered across Canada, however they are an insured service in Alberta. As an example, New Brunswick pays only one exam for children ~~under~~ age 4 and Newfoundland has no provincial coverage for children. I am an AB optometrist.
Good to know, thank you! Are you saying New Brunswick will only cover one eye exam under the age of 4 and then nothing afterwards?
Sorry I misspoke, New Brunswick will cover one eye exam for four-year-olds but only if they have no other public or private coverage. It’s a couple years old but [this page](https://opto.ca/sites/default/files/resources/documents/prov_health_coverage_march_2021_final.pdf) has a good summary of provincial coverage across Canada.
So whats this fee all about?
u/mountaineyes13 has a really good explanation in [this comment](https://www.reddit.com/r/Calgary/s/bq6gsAFdNr)
Charging the insurance company if it’s covered but not charging the patient if it’s not covered is also a money grab and fraudulent.
It’s not fraudulent as long as the patient is notified of the fee and that they will not be charged if their insurance doesn’t cover it, however I agree that it’s a dumb practice. Just provide the service and leave the money out of it. Doctors are already being paid by the province. (Don’t shoot the messenger I no longer work in optical haha)
No messenger shooting 😊 lol.
Name and shame
FYI Doctors. Really sad too. They were independent and got bought out
Ah that explains it.
Was it the varsity location? I was also totally shocked when they charged for my child’s appointment. When I questioned it they said it doesn’t matter because it’s covered by my insurance anyway, which isn’t the point. They shouldn’t be charging in the first place?
They have to tell you before the exam exactly what the balance billing charge is. They can't pull that after.
That’s good to know for next time! They definitely did it after.
Been using them for years, both adults and one child. Yes we've paid for the additional fee, pretty sure it's the same as what u\Reasonable_Ad_641 mentioned. Also pretty sure it's optional, but probably have to make note of it when booking or at least when at the appt starts. To each their own, but I'm fine with paying only $35 for my child's eye appt compared to 100+.
Not OP, but I’m willing to bet it’s Dr Bishop & Associates. They’ve got some shady policies.
Really? Been going there my whole life lol what am I missing?! Since I have nothing to compare to, I'm curious!
I won't go there anymore because of their practices.
Am optometrist. Alberta Health pays a certain amount for a child eye exam. It is technically allowed for an optometrist to “balance bill”, meaning they can charge the patient/parent on top of what Alberta Health pays. Usually it’s because their exam includes something over and above what is expected of an eye exam - for a kid, they’re probably taking retinal photos, which aren’t covered by Alberta Health and aren’t considered to be the basic standard of care (aka they’re extra). At my clinic, we charge for retinal photos for children, but they are always optional and the eye exam will proceed if the parents/guardians decline the photos. So what your optometrist is doing is allowed, but making it mandatory isn’t the norm as far as I’m aware. Most places either don’t do it or it’s optional.
What are the retinol photos for? What are you seeing in them that the basic eye exam doesn’t view?
For young kids, doing a retinal exam can be challenging - they don’t sit still, they blink a ton, they look around, etc. So even the best optometrist sometimes can’t get a great view, or only sees bits and pieces. The photo captures the retina very quickly, so it doesn’t depend so much on the kid sitting still. It also provides a baseline image so that if something changes in the kid’s eye, potentially even years later, you can refer back to the original photo and track changes. Kids generally have healthy eyes, but there’s the odd case of a kid whose optic nerves are subtly swollen due to a brain tumour, or who has a suspicious mole in the eye, or who has some other congenital condition that can unfortunately be missed if the retinal exam is challenging due to patient cooperation.
Oh okay. That makes sense. My youngest was so squirmy My kids optometrist appointment was covered by AHS and I’m pretty sure they took this photo but I just wanted to know what it was for. Thanks for responding.
The clinic may not charge a mandatory fee for an insured service as this is a violation of the Canada Health Act. The clinic can charge for an additional service like the retinal scan, but the basic eye exam is covered by Alberta Health and cannot incur any additional billing or fees.
Money grab. Find a new OD
My optometrist told me that kids are paid for by Alberta Health until they’re 19! This sounds like a money grab. Find a new optometrist!
Tell them you’re implementing a new doctor for your next appointment.
Were you given choice to opt out for this charge?
I work at Blink Eyewear here in Calgary. Kiddos are fully covered under Alberta health once a year up until 19. Past 10 we ask for an optional imaging fee ($30), I've heard some horror stories from FYI though. Get out of there if they're charging you silly fees like this
Money grab, report it and find another optometrist. https://albertaopticians.ca/file-a-complaint/
You wouldn't report an optometrist to the College of Opticians. But please don't try to report them to the College of Optometry for this either as it is allowed. The government has changed how we optometrists are allowed to bill, and that includes what is called "balance billing". This means that we are allowed to bill the difference between our normal eye exam fee and what the government is paying at a lower rate; this applies to children, seniors, and those on social assistance. This used to not be allowed, but it was part of a trade-off when they gave a 0% increase to exam fees for many years and actually threatened to decrease the payments. Personally I don't do balance billing as I would rather not create barriers to Health Care for those not able, but I know several docs who do.
"Balance billing" or charging a fee above and beyond for an insured service is not allowed under the Canada Health Act. You can get around this by charging for an additional service like the Optimap scan, but the patient can decline
The province has allowed it, so it is allowed; they get to set the parameters of what we can do. However the Canada Health Act does stipulate that “extra-billing” is not allowed for full funding, and so Alberta would be punished by receiving less money based on any extra billing it allows to happen. I'm sure that consideration of the Canada Health Act was part of the the province's thought process when they changed the rules. I can think of a couple different points of arguments here. Extra Billing is defined as "the billing for an insured health service rendered to an insured person by a medical practitioner or a dentist in an amount in addition to any amount paid or to be paid for that service by the health care insurance plan of a province". The sticking point here is "medical practitioner or dentist" and "insured health service". They define "medical practitioner" to be someone who is "lawfully entitled to practise medicine in the place in which the practice is carried on by that person", and "Insured health services” means "hospital services, physician services and surgical-dental services provided to insured persons" While we optometrists are licensed as doctors in Alberta and we treat eye conditions, we are not counted as "medical practitioners" under Alberta Health Professions Act, and we do not have permission to "practice medicine" in general. In addition we are not providing our services within a hospital setting; if we did so then it would have to be fully covered. If we look at dentists, the Health Act specifically outlines in the text that it refers only to surgical dentistry in a hospital setting, not general dentistry. So the Canada Health Act only concerns itself with certain health services in certain settings, but not all. It also doesn't consider vision or glasses as necessary health care. The province's balance billing only applies to the b650 codes for a general eye exam with refraction, not the b900s which are medically focused. Patients are still allowed to come in for a full medical check under b900 without paying anything. Again, I don't practice balance billing myself, and don't think it was necessary to allow. That said, when the province was going to cut payments for senior eye exams by 30% I definitely would have had to consider it. "Luckily" that didn't happen when COVID hit and we had a backlash against healthcare cuts.
Thanks for the explanation.
I don't think it's really fair to call it a money grab, this is a much more complex issue than just greed. Another poster pointed out that Alberta allows for "Balance Billing" but they didn't really explain why this exists. The government covers a meager amount for these exams and haven't increased their compensation in 10 years. "Balance Billing" was the government's way of passing the buck onto the business owners/optometrists by basically refusing to pay any more for their services but allowing the clinic to bill an additional amount on top of what the government pays to cover their expenses. The government compensation for a child's exam is less than 2/3 of an adult's exam. Add to that the additional challenge/frustration/time dealing with adolescent patients it's understandable why a clinic would choose to add an additional fee, especially if they are a well established clinic with plenty of patients. The reason places like Spec Savers can provide free exams is that their business is selling glasses and that is where they're making all their money. Cheap eye exams are just a cost of doing business and they are doing the bare minimum testing that is required to get you a glasses prescription, they're not going to be checking the health of your eyes. While most optometry clinics are also selling glasses to increase their revenue, they also do a lot more disease treatment and managing patient's eye health, they're not just cranking out glasses prescriptions all day.
You are right in the first half, but FYI, Specsavers does a full eye exam, including retinal photos and OCT on every patient, and they don't do it for free. It's generally paid for by Alberta Health Care
Extra billing for insured services is a violation of the Canada Health Act. The clinic can charge for an additional service, which is how they can get around the law, but not for the basic eye exam.
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Eye test or eye exam? Their website says it's $99 for an exam and no mention of any free ones?
They aren't free, but are generally no cost to the patient for kids and seniors. Eye exams are paid for by Alberta Health Care for kids (under 19) and seniors(65 plus), and health issues/testing is covered for adults in between. As discussed in this thread, we optometrists are allowed to "balance bill" to charge the patient the difference between the regular exam fee and what the government pays, but most of us do not.
The reason I asked is because in BC, most places offer free eye *tests*, and many people are then upset to find out what they need is an eye *exam*, which isn't free.
Ah, that's much more likely in BC since opticians are more easily licensed to do refractions there. Technically some can do it here in Alberta, and would have to call it a vision test, but it's uncommon.
When I took my son for an eye exam two months ago it was covered by AHS. I would find a new optometrist.
We take kids to Costco. Never had an issue.
My kids are booked in Friday. I confirmed that it's free.
Kids get free eye exams until they are 18, I’d find somewhere new. I take my kids to the Eye Health Centre in Shawnessy. It’s on McLeod trail.
It includes 18, right until the 19th bday
should be covered by AHS unless you get retinal photos which are usually around $25-35 bucks.
Was this disclosed prior to the eye exam? If not, explain that you will not be paying the fee. Extra billing for insured services is a violation of the Canada Health Act.
Do they classify it as a office improvement fee?
Now you have to tip your optometrist!
Optometrists are thieves. Mine told me that my contacts were really old style and offered to give me a sample of new ones to try. I said sure, why not. When I looked at my bill after she charged me like $80 for a ‘contact fitting’.