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Insurance Providers

Orthoses (braces) are used in the treatment of serious and complex medical conditions (see Medical Conditions).  Access to funding is important for patients to address their morbidities, manage pain and facilitate safe mobility and independence.  Early and appropriate orthotic treatments save costs for payers by allowing patients to exit the health care system sooner, avoid long term disability, prevent co-morbidities (and the costs associated with them) and return to independent living and work.

 

Certified Orthotists CO(c) and Certified Prosthetists CP(c) have been credentialed in Canada for over 50 years.  There are approximately 500 Certified Orthotists/Prosthetists in Canada.  Only those professionals that have been CBCPO credentialed through OPC can use the Certified Orthotist CO(c) or Certified Prosthetist CP(c) titles.

 

Certified Orthotists are recognized health care specialists who treat conditions of the neuro-muscular skeletal systems of the body with custom-made or custom-fit orthoses (braces).  Certified Orthotists are the highest trained and most knowledgeable health professionals in head-to-toe orthotic treatments.

 

The treatment process employed by Certified Orthotists CO(c) protects payers from fraud for the following reasons:

  • CO(c) do not prescribe
  • CO(c) require a prescription from an authorized medical professional to render treatment… the independent prescriber determines the medical necessity for orthotic treatment
  • Orthotics is their core profession…CO(c) earn their credential only after completing all these requirements:
    • a university degree
    • 2 years of post-graduate diploma in an accredited prosthetic and orthotic program
    • 2 years in an orthotic Residency, under the supervision of a Certified Orthotist CO(c)
    • Successfully challenging national written and practical board exams
  • Bound to professional conduct standards contained in the Canons of Ethical Conduct
  • OPC has an independent complaint process to investigate and adjudicate

To find a Certified Orthotist near you, use our Find A Professional feature.  Only credentialed and active professionals appear on the Find A Professional site.  If you have any questions, please contact OPC at 613-595-1919 ext. 1 or via email at info@opcanada.ca.

 

Orthotics and Insurance Policies

How Insurance Companies Can Provide Patients with the most Appropriate and Cost-Effective Care:

  1. Recognize appropriate expertise – recognize Certified Orthotists and Certified Prosthetists in claims policy for the uniquely trained and specialized health professionals they are.

 

  1. Revise archaic policy wording - “One limb for life”, “Usual and customary costs”, “least cost option” are all examples of inappropriate wording that does not recognize the unique treatment requirements for each patient and the value of the most appropriate treatments.

 

  1. Partner with OPC to eliminate fraud - Orthotics are Certified Orthotists’ livelihood. They are the least likely to commit acts of insurance fraud that would jeopardize their career.  They do not have a conflict of interest by being a prescriber and a provider. Controls are built into the treatment process employed by Certified Orthotists including the requirement for a prescription by an authorized medical professional and appropriate documentation.

 

  1. Support OPC’s efforts to improve public funding - OPC wants to see better public funding for treatments that address limb loss and limb deficiency and for orthotic treatments that address debilitating medical conditions.  By supporting our efforts for improving public funding, the burden on private health insurance funding is reduced.