PGY2 Lecture: Family Medicine Billing Practice Cases (Pt 2 of 2)

Lecture recording for the University of Toronto Family Medicine PGY-2 residents. This lecture goes additional details of Family Medicine billing in Ontario including Premiums, Modifiers, Billing Rejections, WSIB Billing, Uninsured Billing and Practice Cases

𝗧𝗼𝗽𝗶𝗰𝘀 𝗖𝗼𝘃𝗲𝗿𝗲𝗱:
0:00 - Intro
3:43 - Premiums & Modifiers
11:06 - Dealing with Rejected Billings
13:43 - Uninsured Billing
17:16 - WSIB Billing
20:36 - Practice Cases

𝗥𝗲𝘀𝗼𝘂𝗿𝗰𝗲𝘀:

Correction 12:54 : Health Number Release Service Phone is: 1-888-360-7530, 33:06 - E409 is a typo in the SGFP document, should say 1700-2400 for the premium.

𝗗𝗶𝘀𝗰𝗹𝗼𝘀𝘂𝗿𝗲𝘀:There are no conflicts of interest to disclose. These slides are for education purposes only. Any information, views, and opinions expressed are solely those of the presenter and are not a substitute for financial advice specific to your personal situation.
The OMA and CMA (Joule) have made every effort to ensure that the examples presented in this document represent “best practice” billing.
All physicians must personally read their MOHLTC fee schedule preamble and be responsible for meeting all criteria for the appropriate billing of the services they provide.
When in doubt consult your MOHLTC advisors

#FamilyMedicine #FamilyDoctor #Billing

[labadee]

Thank you Dr Steph, I recently moved over from Australia to work and your lectures have been a great help!

[BreakingBadDebt]

𝗧𝗼𝗽𝗶𝗰𝘀 𝗖𝗼𝘃𝗲𝗿𝗲𝗱:
0:00 - Intro
3:43 - Premiums & Modifiers
11:06 - Dealing with Rejected Billings
13:43 - Uninsured Billing
17:16 - WSIB Billing
20:36 - Practice Cases

*Correction to 12:54 - Health Number Release Service Phone is: 1-888-360-7530
33:06 - E409 is a typo in the SGFP document, should say 1700-2400 for the premium.


𝗥𝗲𝘀𝗼𝘂𝗿𝗰𝗲𝘀:

[omarmahgoob]

Can a family physician bill for ear flushing (G420 in addition to A007)? Some say it is a third party and the patient has to pay.

[tonyssheep]

Thank you so much for these lectures dr. Steph. I have a question on CCM practice model. I have non-clinical commitments during weekdays so I will only see pts on weekends. Does this mean I can bill 30% premium with Q016 for all my CCM patients? Thanks.

[auslander]

I believe you mentioned in previous videos that community EMRs have integrated billing software (plugins?)... Any automatisation assistance for that matter? I mean, does soft helps to generate codes or it is just for submission only?

[aleemahmedabdul]

Hello
Thanks for lovely video
I am keen and many like me are struggling to find info about following topics
1. Place to access uptodated guidelines of Canadian practise - for example in UK we have GPNotebook - complete summary of NICE guidelines ... any similar website or application for new IMGS trained outside canada

2. How the ofamily medicine system or health care system works - here GP assessment if needed A&E - walkin centre - A&E hospitals etc .,

3. How to prepare for mccqe part 1 - tips and resources to follow

4. How to select a work place

Many Regards
Dr AAA
UK - GP trainee

[btrcyyl]

Hi Dr. Steph, I have a few billing questions. 1. Special premiums in a PEM (e.g. LTC, home visits etc). Do these patients have to be rostered to you or can they be patients you see outside of your regular FM practice i.e. a side gig? 2. My understanding is that G365 cannot be billed with A003 but K131/132 is okay? 3. I have applied to MOH to join a FHG but it hasn't been approved yet. Do I bill tracking/exclusion codes only after I officially join the FHG (and bill Q200A)? Or do I have to go back and bill the tracking codes afterwards? 4. For patients who had paps within their last 3 years that were done by their previous FMD, can I still bill the tracking code even though it wasn't me who did it? Thank you!

[JW-wsop]

Can you bill A888 for all Walk in clinic visits (scenario #4)? Or only if it's after hours, or weekends?

[BreakingBadDebt]

Correction to 12:54 - Health Number Release Service Phone is: 1-888-360-7530
33:06 - E409 is a typo in the SGFP document, should say 1700-2400 for the premium.

[JW-wsop]

For the E409 (scenario #13), shouldn't the premium be from 1700h-2400h? Is that a mistake on the SGFP document?

[Bonjourlhiver]

Hi Dr.Steph, thank you for your informative video. Regarding WSIB billing (20:20), if a patient comes in for a workplace injury, but if the workplace is not registered with WSIB or if the patient doesn't know, can we still bill OHIP? or is that uninsured service?