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Frequently Asked Questions/Contact

FAQs:

Do I need a referral?

NO. You do not require a referral to book an assessment and are welcome to book your own appointment using the “Book Appointment” tab at the top-right of the screen.

What is the cost of a comprehensive assessment, and is it covered by Alberta Health?

The cost for a comprehensive assessment is $895 and includes all available testing. Our services are NOT currently covered by Alberta Health. There is a public neurovestibular unit at South Health Campus in Calgary that offers similar testing, which is covered by your provincial health plan. You can request a referral from your family doctor or audiologist, but our personal experience from having previously referred patients there for 10 years, and from speaking to current patients at our clinic who have been referred there more recently, is that wait times are now in excess of 2 years in many cases – if they are accepted at all.

We reached out to AHS in an attempt to initiate discussions on whether/how we might be able to help with their excessive backlog by contracting our services and having your assessment covered by your provincial health plan. Unfortunately, they indicated that is not something they are interested in pursuing or discussing any further at this time. Officially, they claim that there is no excessive wait time for neurovestibular testing and that it is offerred at multiple locations throughout the province. We are not aware of any AHS facilities other than South Health Campus and the Glenrose Rehabilitation Hospital in Edmonton that have dedicated neurovestibular units offering truly comprehensive assessments (some units may have a set of VNG goggles, but that does not constitute a comprehensive neurovestibular assessment), and we continue to hear from patients every week that they are facing 2+ year wait times, or that their family doctor is not even able to get a referral to South Health Neurovestibular Clinic accepted.

In any case, we are just as frustrated as anyone that people are suffering for so long without answers to their life-altering balance and dizziness problems, and that this is such a neglected area of health care, which was exaclty the motivation behind opening this clinic in the first place. While we would love for our services to be covered by AHS, the only way we are able to offer them currently is through private pay.

Why does the assessment cost so much?

While we genuinely want nothing more than for our services to be accessible, there are a number of reasons why we have to charge what we do. The bottom line is that it is the only way we can sustainably operate the clinic and continue offering the much needed services that we provide. Our primary purpose is to help people who are suffering from a wide range of vestibular disorders by providing world-class diagnostic testing that is woefully lacking/not reasonably accessible publicly, and there are substantial costs associated with doing that, including:

  • Extremely expensive equipment and software: A truly comprehensive neurovestibular assessment cannot be performed with a single piece of technology. It requires an entire suite of highly specialized medical equipment and associated analytic software, all of which carries a high cost.
  • It is incredibly time-consuming: Just the clinical component of your assessment is 3hrs long, and there is a roughly equal amount of time that goes into detailed data analyis and reporting after your appointment. We can only see a maximum of 2 patients per day, and the clinician is typically dedicating 4-5 hrs of focused time to each patient. 
  • Your audiologist is a highly trained specialist who has dedicated an immense amount of time to developing the required skills and experience to be able to perform advanced neurovestibular assessments, competently interpret the data, and put it all together into a coherent picture of how it relates to your specific symptoms and history. They have 8 years of university education plus additional post-graduate training and certifications in  advanced vestibular diagnostics.
  • There are also numerous other operating expenses associated with any medical clinic, including high insurance premiums, professional and regulatory fees, and a various administrative costs. 

We recognize that the cost of assessment is substantial, but we believe there is tremendous value in what we provide and that it is a very worthwhile investment in your overall health and well-being. We greatly appreciate you putting your trust in us to help you get to the bottom of your balance and dizziness problems, and hope to be able continue serving patients for many years to come. 

A helpful analogy that many people may be able to relate to is this: Paying for a private neurovestibular assessment at our clinic is like paying for a private MRI. While MRIs are covered by AHS, you may have to wait a very long time to get one. In the meantime, you may be needlessly suffering and unsure as to what treatment path to pursue because you can’t get an accurate diagnosis until you have the MRI. So, you pay to get one completed quickly in order to get yourself on the most appropriate treatment path as soon as possible. Our comprehensive assessment is priced similarly to a private MRI,  and can actually give you far more valuable information about the overall function of your entire vestibular system. As with private MRIs, there is very little wait for our services and we can typically see you within 1 week. 

Will my insurance cover this?

More and more insurance providers are beginning to recognize that audiology is more than just hearing aids, and includes vestibular practice as well,  but we cannot get pre-determination of coverage on your behalf so you must contact your insurance provider directly yourself. They typically require the following information:

Clinic Name: Alberta Balance Centre

Phone: 403-764-3787

Name of Service: Diagnostic Vestibular Assessment

Cost of Service: $895

Service Provider: Aaron Byrnes, M.Sc., R.Aud

Designation: Clinical Audiologist (Registration#: 4648)

Some insurers are still confused as to what a “Diagnostic Vestibular Assessment” means, because there are so few dedicated vestibular audiology clinics in Canada. We are working hard to educate insurers and advocate for better coverage of this important branch of audiology. In the meantime, the key point to communicate with your insurer is that you are seeking an advanced “audiologic assessment”, which is being performed by a “registered audiologist”. Audiology is a fully recognized and regulated health profession that all insurers should be aware of. 

We are not able to direct-bill your insurance provider at this time, so you will have to pay out-of-pocket and submit for reimbursement. You will be provided with a detailed invoice/reciept containing all of the necessary information for reimbursement.

What about the cost of treatment?

Treatment recommendations depend largely upon what is found during the assessment and can vary significantly. One common recommendation is vestibular rehabilitation therapy (VRT). If VRT is recommended, we typically give you an initial set of home exercises as part of your comprehensive assessment. Subsequent VRT sessions are $150 each. Our goal is to make your treatment as home-based as possible so you don’t require repeated in-clinic visits, and most people only require 1-3 follow-up sessions. If it seems you would benefit from more frequent and intensive VRT performed in-clinic, we generally refer to excellent vestibular physiotherapists with whom we work regularly. 

Do I need to be actively symptomatic at the time of my assessment in order for the tests to be useful?

NO. There are many things that may produce episodic/fluctuating symtpoms, which may or may not be present at the time of your assessment, but there are still clearly identifiable markers/abnormalities that can be measured if there is an underlying vestibular problem that is causing them. Even when results are perfectly “normal”, that is still extrememly informative, because there are only certain things that can produce episodic symptoms that don’t result in any subsequently measurable abnormalities. It is, of course, ok, if you are symtpomatic at the time of your assessment, but it is not necessary. 

Will any of the tests make me dizzy or sick? And do I need someone to drive me?  

The short answer in the vast majority of cases is NO, but there are always some exceptions. Anyone who is already not able to safely drive because of their symptoms should not drive to their apppointment. Most of the tests we perform do not induce or increase dizziness to any significant degree, and if they do, it is always temporary. There is no risk of any test causing any sort of permanent harm, or making any underlying condition worse. The worst case scenario is that some tests could temporarily exacerbate your symptoms or make you feel unwell for a short time. You are always welcome to relax at the clinic for as long as need if you don’t feel well.

There are two tests that are most likely to induce/increase dizziness, and one of them is rarely required (caloric testing). Caloric testing is a test that allows us to deliberately induce vertigo in a controlled manor by irrigating your ear canals with different temperature air or water and measuring an eye response called nystagmus. It has largely been replaced by far less invasive technology (vHIT) that does not induce vertigo, and also provides far superior diagnostic data. There are still rare circumstances where caloric testing can be valuable, but it is not routinely done. It would also be thoroughly discussed with you prior to being performed, and you always have the option to decline. The only other circumstance where testing will definitely induce dizziness/vertigo is if you have BPPV (you can read more about BPPV on the “Helpful Resources” page). BPPV (often referred to as something like: “loose ear crystals”) requires us to accurately identify where those loose crystals are located in order to properly reposition them for you. This means we have to place your head in different positions and observe for a vertigo response. I.e. we have to deliberately provoke it in a controlled manor in order to accurately determine where it is and what maneuver is required to fix it. Again, this is very much a temporary provocation and is actually very good news, because once identified, we are able to immediately correct it.

Do you offer specific tests in isolation?

Yes. Typically we only do specific tests in isolation if it is being requested by a specialist such as an ENT or neurologist, but there are certainly some other circumstatances where you may only need cetain tests. For example, some people may have had VNG completed somewhere else, but they haven’t had VEMPs and/or vHIT. We are always happy to accommodate special circumstances and help in any way we can. Please get in touch with us if you require specific tests in isolation. 

Contact Us

Please see answers to the most commonly asked questions just to your left. There is also a great deal of information on the website that typcially answers most people’s questions, including a detailed list of all the various tests we perform and treatments that are offerred. There is also a BPPV self-assessment tool in “Helpful Resources” to help clarify some common confusion regarding that particular condition.

If you would like to speak directly with the audiologist to have a detailed discussion about your specific case history prior to booking an in-clinic assessment, you will need to book a phone/online consult, which can be done through the “Book Appointment” tab at the top right of your screen. Due to the high volume of calls and emails requesting this type of consult, and the audiologist’s very limited time between conducting clinical assessments, data analysis, and report preparation, he dedicates an entire day each week to conducting phone/online consults. This allows you to schedule a specific time that will be dedicated entirely to answering your questions/reviewing your personal history, and avoids frustrating games of phone tag.

If you have any questions that are not answered on the website, or that do not require a personal consult with the audiologist, please feel free to send a message below. Please note that the clinic phone may not be answered at all hours during the day due to limited staffing, but messages are checked daily and calls returned as soon as possible. 

Phone: 403-764-3787

Fax: 587-962-5787