BC MSP fee changes, AMA fee navigator launches, and ON EMR funding program ends

Medical service fees in Alberta and BC have recently had some updates and changes have also occurred to the OntarioMD funding program. Find out how these changes may affect you below.

Claiming phone calls on Alberta HLINK submissions | ClinicAid blog

Alberta physicians are able to claim phone calls with patients in their medical billing, as long as certain conditions are met.

Phone calls for the following patients may be claimed using the appropriate service codes found in the Schedule of Medical Benefits (SOMB):

Why documentation is important for Alberta's physicians | ClinicAid blog

The new Schedule of Medical Benefits that was released by the Alberta Medical Association and came into effect on April 1st, 2014 reiterated the importance of proper documentation for all patient encounters. It also added an extra rule that requires physicians to record the time spent providing time-based services for each day of service. This time log should be kept chronologically and be part of the physician's documentation of patient encounters.

Proper documentation is important for personal record keeping, but also for reviews conducted by the Alberta Health Program Monitoring and Compliance Unit. In order to keep sufficient documentation of patient encounters, try these tips:

1. Purchase a small notebook and writing tool (pen/pencil) that can easily fit in a pocket. You should keep this notebook with you at all times to quickly record and track phone calls and encounters, as well as log time spent performing time-based services.* 
2. Record how many times you are speaking with facility staff about a patient. These calls are often missed in charts and are overlooked.
3. Record every patient encounter in the patient's chart. Include the visits that have been billed on a cumulative time basis, callbacks, or multiple encounters on the same day. EMR systems can be particularly useful for these records, as well as keeping time logs for patients. 

*Some physicians might find a time management app most useful for keeping track of time-based services. Apps that can produce printable or downloadable records are especially useful.

Proper record-keeping will be useful for billing purposes, but are also extremely important for any audits or billing reviews that may occur. Documenting patient encounters accurately should become second nature to a physician in order to ensure all details are provided, while also making sure billing opportunities are not missed. Claims that are often missed are for phone calls with patients.

More tips on documentation methods and specific requirements for time logs can be found on the Alberta Medical Association's website.

New Changes to Alberta Health Schedule of Medical Benefits | ClinicAid Blog

As of April 1st, 2014, recent changes made to the Alberta Health Care Insurance Plan (AHCIP) Schedule of Medical Benefits will come into effect. These changes will affect some codes, facilities, and pricing rates with codes and facilities being removed or added and pricing amounts being changed.

We have updated ClinicAid with the applicable changes to make as many as possible automated within the software. A quick video walk-through of the changes to ClinicAid's medical billing software has also been created and can be found on our YouTube channel, along with other useful tutorials.

Code Changes

Some of the codes that have changed are as follows:
New Service Codes Available as of April 1st, 2014

• 03.05GA 
• 03.44A 
• 07.54B 
• 09.02D 
• 09.02E

These codes will only be found in the search results if the service date for the code is April 1st or later. Trying to bill for these codes for a service date prior to April 1st will result in an error as we've updated ClinicAid to ensure that the codes are billed accurately.

Service Codes No Longer Available as of April 1st, 2014

• 03.05NT
• 03.05ZF
• 03.05BT
• 03.05XT
• 03.05BP
• 03.05BU
• 03.05VQ

These codes will not be available after March 31st, 2014. Much like the new codes, ClinicAid will check the service date you are trying to bill for in order to ensure that you are billing accurately. If you are trying to use on of these codes for a service date after Mach 31st, you will receive an error when saving the bill.

Changed Fee Modifier

The COMX fee modifier for the 03.03D service code (Hospital visits) has been removed and replaced with the COINPT fee modifier. 

Pricing Changes

Some codes have had their rates adjusted. For example, code 03.03D's base value before April 1st was $33.82. As of April 1st, the new base value for this service code will be $40.58. Around 2500 service codes have been updated with new prices.

Facility Changes

A number of facilities have been removed while new ones have been added to the list of valid facility numbers. Again, these will be available depending on the service date when billing within ClinicAid. 

It is important to make note of these changes in order to ensure you are submitting your bills to AHCIP correctly. For more information and the full details behind the changes, as well as an exhaustive list of new codes, prices, and more, please visit the Alberta Medical Association's Billing Corner and view the PDF version of the new Schedule of Medical Benefits that comes into effect on April 1st, 2014.

After-Hours Billing Tip for Alberta's Medical Professionals | ClinicAid Blog

Have you been working after-hours lately? Maximize your billing opportunities by following this useful after-hours billing tip!

Billing for after-hours work for the 2014 statutory holidays

If you're working after hours on stat holidays, there are various modifiers you can use based on the hours you are working. The after-hours time premium (03.01AA) is only applicable to services that are provided at a hospital, auxiliary hospital, active treatment centre, nursing home, or AACC/UCC, not at a physician's private office.

For stat holidays, a 24 hour period is split into 3 increments with different modifiers that are based on the hours worked. If you are working across multiple increments, you are able to use two modifiers for the 03.01AA code to cover the times you are on duty. Please note that there are certain maximums that apply when claiming this health service code.

If you're visiting with a patient before and after midnight, you should claim the after-hours premium on two separate dates of service, one for the date before midnight and one for the date after.

There are also various callback codes that can be used for after-hours work. 

For more information on all of these codes and the appropriate ways to bill them, please see the Alberta Medical Association's after-hours billing page for 2014 stat holidays.