Patient guide
Third-party requests and reports
Learn what may be involved when an employer, insurer, school, lawyer, government program, or another organization requests medical information or documentation.
What is a third-party request?
A third party is a person or organization other than the patient. Examples may include an employer, insurer, school, lawyer, government program, benefit provider, or another organization.
A request may ask for a form, note, certificate, report, assessment, medical-record information, or a professional opinion. It can still be a third-party request when the patient receives the document and brings it to the clinic.
What the clinic may need to do
Clarify the request
The clinic may need to confirm what information or opinion is required, why it is needed, who requested it, and when it is required.
Confirm authority and consent
The clinic may need to confirm the patient's authorization, the requester's authority, and what information may be collected, used, or disclosed.
Review and assess
The physician may need to review relevant records and decide whether an appointment, examination, test, or additional information is required.
Prepare and deliver the response
The clinic may need to complete a form or report, document what was provided, communicate with the requester, and use an appropriate delivery method.
Who is responsible for payment?
There is no single answer for every request. Some related physician services may be covered by OHIP. Some third-party services may be billed to the patient or to the organization that requested them. Other services may not permit a separate fee or may be subject to specific program rules.
Who pays can depend on who requested the work, the purpose of the request, the agreement between the parties, and the Ontario rules that apply.
Before the work begins, ask the clinic to confirm the expected service, who is responsible for payment, the estimated fee, and the payment terms. If additional work becomes necessary, the clinic should explain that before proceeding whenever possible.
Privacy and the scope of the request
A third-party request does not automatically permit access to every part of a patient's medical record. The clinic must consider the patient's authorization, the requester's legal authority, the purpose of the request, and applicable Ontario privacy requirements.
A specific request can help reduce unnecessary disclosure, work, delay, and cost. Patients may ask what information will be provided, who will receive it, and how it will be delivered.
How long may the request take?
Completion time can depend on the complexity of the request, the amount of information involved, whether an assessment is needed, the physician's availability, and any legal or program deadline that applies.
Ask the clinic for an expected completion date. If the requesting organization has a deadline, provide that information to the clinic as early as possible.
Questions to ask your clinic
Your clinic is the best source of information about a particular third-party request.
- Who requested the form, report, assessment, or information?
- What exactly is being requested, and why?
- What authorization or consent is required?
- Is an appointment, examination, or additional information needed?
- Is any part of the service covered by OHIP?
- Is the patient or the third party responsible for payment?
- What fee is estimated before the work begins?
- When is the request expected to be completed?
- How will the information be delivered securely?
Important note
ClinicFees.ca provides general education only. It does not determine whether a specific third-party request is authorized, insured, uninsured, billable, taxable, permitted, refused, waived, payable, or subject to a particular deadline. Your clinic's own policy and applicable Ontario consent, privacy, billing, and program requirements apply.