Your Name and Registration Number Have Been Misused

What Should You Do?

The College sometimes hears from physiotherapists who have had their name and/or College registration number used by others for fraudulent billing. It can be quite distressing.

The College only oversees the practice of physiotherapists and as such, the only way the College can make further inquiries is if the clinic where your name and registration were misused is owned by a physiotherapist.

If this is the case, you can file a formal complaint about this physiotherapist.

If the clinic is owned by another type of regulated healthcare provider, you can file a formal complaint with their respective College.

We encourage you, regardless of if your registration number was misused by a regulated healthcare provider or someone else, to forward us an overview of any information you have received from the insurer, along with any related correspondence about your number being misused.

The College will open a file so we have it on record that another person or organization used your name and registration number without your consent. To open a file, we need you to email the following to investigations@collegept.org:

• Your name and contact information
• The name and address of the facility
• The name of the clinic owner and/or manager (including contact information), if available
• The dates you worked at the clinic
• The name and contact information of the insurer who contacted you (if available), and
• Any other information you believe would be helpful

You could also consider doing some or all of the following:

If the fraudulent claims are associated with Motor Vehicle Accident (MVA) patients:

• Contact the Insurance Bureau of Canada (IBC) — call or submit a tip online
• Contact the Financial Services Regulatory Authority of Ontario (FSRA) for additional information and/or to submit a tip online.
• Contact the College Practice Advisors at practiceadvice@collegept.org or call 1-800-583-5885 and ask for your name and registration number to be run through the Professional Credential Tracker software. They can pull a report that shows which facilities are currently able to use your name and registration number for billing purposes. Please be aware that the report only covers facilities billing for MVA patients. At this time there is no similar report for clinics accessing monies through extended healthcare benefits.

If the fraudulent claims are associated with extended healthcare benefits: 

• Contact the Canadian Life and Health Insurance Association (CLHIA) — call or submit a tip online

If the inappropriate claims are related to physiotherapy care funded through the Ministry of Health and Long-Term Care:

• Contact the Ministry of Health and Long Term Care — call 1-888-781-5556 or submit a tip online reportohipfraud@moh.gov.on.ca

You can also:

• Contact your local police
• Send the clinic owner a cease and desist letter. Contact the insurer first to see if taking this action would compromise an active investigation of the clinic. You may be asked not to contact the clinic directly. 
• Call your professional liability insurance carrier

The College also has many resources available to assist physiotherapists who are entering practice, starting practice or leaving practice.

Resources

There are a few things you can do to help prevent fraud in the future.

• Regularly audit the claim forms that a healthcare facility submits using your name and registration number. This requirement is set out in the Fees, Billing and Accounts Standard.
• Be aware of the conditions, billing codes (e.g. for MVAs) and dollar amounts being billed for your professional services.
• Never sign blank treatment plans/forms.
• Be cautious when asked to provide an electronic signature. Understand how it will be used and who will have access to it.
• When you leave a practice, ensure you update your Public Register information as soon as possible (within 30 days), as required.
• When you leave a practice provide the clinic owner/manager with a letter saying that they are no longer permitted to use your name and registration number for billing purposes
• Before signing a new contract, discuss your professional obligations to monitor and understand the business’s billing practices. Be clear that your name and registration number should not be used for care or services you do not provide.
• Be selective about the jobs you accept. You could be exposed to inappropriate business practices by clinic owners who put up barriers to meeting your professional obligations.
• If the job is offering a huge sum of money for minimal work, then it is likely too good to be true. Be cautious and don’t hesitate to ask questions.