Why a referral is required
Dermatology is a specialist service. Under OHIP, a specialist consultation is insured when a patient has been referred by another physician or a nurse practitioner who has assessed the problem and decided that specialist input is needed. The referral tells us why you are being sent, what has already been tried, and your relevant medical history, and it allows our dermatologists to decide how quickly you need to be seen.
For these reasons we cannot book patients who call us directly. Ask your family physician, nurse practitioner or another specialist to fax a referral to 905 625 5650. If you do not have a family doctor, a walk in clinic can refer you. Once the referral has been reviewed we will telephone you to book.
The one exception is clinical research. Patients interested in a study may contact research@dermcare.ca directly without a referral. See research at DermCare.
What OHIP covers
With a referral and a valid Ontario health card, there is no charge to you for:
- Consultation and follow up visits with the dermatologist
- Skin examination, including examination of moles with a dermatoscope
- Skin biopsy where medically indicated, and the pathology reading
- Removal or treatment of skin cancers and lesions that are medically indicated
- Narrowband UVB phototherapy ordered by the dermatologist for a recognised diagnosis
- Prescription of medicines, including systemic and biologic therapy where indicated
- Reports to your referring doctor and family doctor
Medications themselves are dispensed by your pharmacy and paid for through your drug plan, the Ontario Drug Benefit programme, Trillium, or out of pocket. Some biologic therapies require an application to a coverage programme, which the clinic completes with you.
What is not covered
OHIP insures services that are medically necessary. The following are not insured and are not provided under a referral to DermCare:
| Service | Notes |
|---|---|
| Cosmetic treatments | Treatment of a skin change that is a cosmetic concern only, with no medical indication. DermCare does not offer cosmetic services. |
| Removal of benign lesions for appearance | Skin tags, benign moles, seborrhoeic keratoses and similar lesions removed because of how they look rather than for a medical reason. Where there is a medical reason, for example a lesion that catches and bleeds, it may be insured. The dermatologist will tell you which applies. |
| Some forms and letters | Forms for insurance, employment, school or travel, and letters requested by a third party, are not insured by OHIP and carry a fee set out in the Ontario Medical Association's guide to uninsured services. The clinic's fee schedule for uninsured services is being confirmed. |
| Missed appointments | OHIP does not pay for appointments that are missed without notice. See cancellations below. |
| Mole mapping | Whether total body imaging or mole mapping is offered, and whether it is an uninsured service, is being confirmed. |
You will always be told before any uninsured service is provided, and what it costs, so that you can decide.
How long a referral is valid
A referral covers the problem you were referred for and any follow up the dermatologist arranges for it. Once your dermatologist discharges you back to your family doctor, or if you have not been seen for an extended period, a new referral is needed to return. The clinic's policy on referral validity periods is being confirmed.
If a new skin problem arises while you are under our care for something else, tell the dermatologist at your visit. It can often be dealt with at the same time. If you are no longer attending, ask your family doctor to send a new referral describing the new problem.
Rebooking and follow up
Follow up appointments are booked before you leave the clinic, or you are called when the appointment is due. Phototherapy sessions are scheduled as a block by the phototherapy nurse. If you need to change a follow up appointment, call 905 625 5600 as early as possible.
If you were told to return and did not receive a call, or if your condition worsens before your follow up is due, call us. Please do not ask your doctor to send a second referral for a problem we are already treating. A telephone call is faster.
Cancellations and missed appointments
Appointments with a dermatologist are in demand. If you cannot attend, please call 905 625 5600 as early as possible so that the time can be offered to another patient who is waiting. The clinic's cancellation notice period and any fee for appointments missed without notice are being confirmed and will be stated here.
A patient who misses a first appointment without notice is contacted once to rebook. Where a patient does not attend twice without notice, the referral is closed and the referring doctor is informed. A new referral is then required.
Keep your contact details current
We book and follow up by telephone. If your phone number changes between the referral being sent and your appointment, call us. An unreachable patient is the most common reason a referral is returned to the referring doctor unbooked.