Accounting

The term “accountant” is unregulated in the province of Ontario.  This means that anyone can call him or herself an accountant, even with little or no formal training and experience.  To ensure your accountant is fully trained for the financial tasks and projects ahead, engage a professionally designated accountant.

Visit the following resources to learn more:

  • Accounting and New Chiropractors: SRJ Chartered Accountants have created a New Graduate Checklist, specific to the chiropractic industry. Following this list will help ensure a smooth transition into your career by addressing some of the necessary steps required to properly establish your business and avoid costly errors.

Selecting an Accountant

The accountant you choose may become your most valuable resource.  Begin by selecting an accountant with a professional designation such as a chartered accountant (CA), certified management accountant (CMA), or certified general accountant (CGA). Professionally designated accountants (CAs, CMAs, CGAs) will:

  • Have formal education and training required to fulfill advanced business and financial functions.
  • Adhere to a code of ethical principles
  • Keep skills current through mandatory continuing professional development.
  • Carry liability insurance and are subject to regular practice inspections

Before engaging the services of an accountant you should confirm that:

  • Their services meet your needs.  You may require planning and preparation of financial statements or tax returns, representation to the bank or Revenue Canada.  Ultimately, before you select an accountant establish which services you require.
  • You can reach them conveniently.
  • They explain accounting in language you can understand.  If your knowledge is limited, select someone who will be able to explain basic accounting concepts and terminology.

What to ask a prospective accountant:

  • Do you have prior work experience with chiropractic offices?
  • Can you provide references of clients who are chiropractors?
  • What is your standard billing procedure and can you provide me with an estimate?
  • Who will do the routine work, yourself or other staff?
  • Are you open to seeking advice from outside experts on specialized practice affairs?

Ultimately, you should select an accountant with whom you can speak freely – someone whose comments and suggestions indicate an understanding of the profession. Most importantly you should select someone who both listens to and hears what you say.

Bookkeeping

The practice’s “books of account” is set up on a computer software package that can be integrated with any other special software packages used for practice management (billings, accounts receivable).

Data entry for your practice’s “books of account” may be done in several ways:

  • Existing office staff
  • Hiring a freelance bookkeeper
  • With your accountant’s office staff

It is often efficient and cost-effective to work with a bookkeeper because:

  • Unusual transactions can be identified by a bookkeeper and reported to the accountant, particularly when preparing records for year-end work.
  • Freelancers are flexible about how, when and where they work, enabling a tailored relationship.
  • Banking transactions performed by office staff can be verified.

All documents for the practice must be kept for at least a 7-year period. After year-end has passed, your accountant will request a list of records and documents from the bookkeeper so as to complete the engagement. These documents may include:

  • Various reports generated from accounting software.
  • Monthly accounts receivable reports (manual or computerized).
  • Original invoices paid during the year.
  • Insurance policies.
  • Leases.
  • Banking agreements.

Fees and Billing

For standard fees, consult the OCA Recommended Fee Schedule.

Social Assistance

Some patients on Social Assistance may have chiropractic coverage. The Ontario Works program is cost shared 80/20 by the province and municipalities and it is administered by municipalities. This means that:

  • Requests for benefits must go to the appropriate Ontario Works caseworker or administrator in the municipality where benefits are accessed.
  • The flexibility to grant discretionary benefits may vary from region to region because of local budgetary constraints.

Some Ontario works offices report having covered the cost of chiropractic services in the past while others report they will be unable to do so because of budgetary constraints. Nonetheless, because budgetary circumstances can change, the OCA recommends that you assist all appropriate patients in applying for these discretionary benefits.

Request for Discretionary Benefits: This template can be used by your patients to request discretionary benefits. The application is from the patient, not the chiropractor. Keep a copy for your records. Procedures vary by jurisdiction, but patients should direct the request first to their caseworkers. The OCA recommends the following:

  • Where possible, the patient should request the discretionary benefit before services are provided. If services are performed before approval they may still be covered, but the Ontario Works administrator may conclude that the patient is prepared and able to pay on their own.
  • Provide a clear diagnosis, related where possible to a specific incident or injury. Requests for maintenance care or preventative care are less likely to be approved.
  • Propose a clearly defined course of treatment (frequency and duration).
  • Provide specific details of the expected benefit to the patient, especially as it relates to improved ability to function at work or in activities of daily living.
  • Include a date when you will provide a progress report and honour that date.
  • Use validated outcome measures (i.e. Roland-Morris, Oswestry, NDI).

Taxes

HST does not apply to chiropractic services. If a chiropractor does more than $30,000 of ‘HSTable’ business he or she must register as a HST entity, charge HST on all applicable goods and services, and remit this minus the off-sets. Applicable services include most items a chiropractor would sell, and non-clinical services such as legal and other reports and rent collected from associates.

Learn more:

Coverage for First Nations

The First Nations and Inuit Health Branch (FNIHB) – Ontario Region of Health Canada provides coverage of chiropractic services to First Nations people as follows:

  • Coverage is available to a maximum of $150 per year with the patient responsible for any charges once this maximum has been reached.
  • This coverage is applicable only after all other insurance coverage (eg. Blue Cross) has been exhausted.
  • The patient will be responsible for a co-payment on each visit ($11.75 for initial visits and $9.65 for subsequent visits), with FNIHB paying the remainder of the fee for the visit, subject to the maximum of $150 per year. For example, if your office bills $50.00 for the visit, the patient pays $11.75 and Health Canada will pay the balance of $38.25.

To access funding, the patient must submit a physician or nurse practitioner referral (original) accompanied by the number of sessions, rate per session and Health Canada share. Funding is available on the date the physician/nurse practitioner referral is made. The patient is also required to present their original Status Card so a photocopy can be made to accompanying billings to Health Canada.

Contact & Billing Information:

Ontario Health, Canada Medical Services
1547 Merivale Road, Third Floor
Postal Locator 6103A, Nepean, Ontario K1A 0L3
1-800-640-0642