Physician s Newsletter. April 2014

Size: px
Start display at page:

Download "Physician s Newsletter. April 2014"

Transcription

1 April 2014

2 CONTENTS MANITOBA HEALTH, HEALTHY LIVING AND SENIORS INSURED BENEFITS CONTACT LIST... 3 NEW CLAIMS PROCESSING SOLUTION (CPS)... 4 CLAIMS UNIT... 5 Electronic User Sites Remittance Download Instructions... 5 ICD Codes... 5 Incomplete Claims... 5 Interest Rates July 1, Re-submissions... 6 Disposal Code Timeline for Submission of Claims... 7 Timeline for Submission of Queries... 7 NEW Chronic Disease Management (CDM) Tariffs... 8 Midwifery Referrals and Provider Number... 9 NEW SIS to WebLink Conversion... 9 Lab Services for Northern Ontario Residents... 9 Request for Prior Approval Form OUT-OF-PROVINCE UNIT Reciprocal Billing PRACTITIONER REGISTRY Change of Electronic User Site Change of Software Vendor Change of Mailing Address Changing or Closing Bank Account Important Message For Manitoba Physicians Regarding Insurance Registry (ireg) Release THIRD PARTY CLAIMS Workers Compensation Board (WCB) Billings PHYSICIAN S MANUAL UPDATES APPENDIX Important Dates for Holiday Closures Fee for Service Mailing Dates April 2014

3 MANITOBA HEALTH, HEALTHY LIVING AND SENIORS INSURED BENEFITS CONTACT LIST Practitioner Registry General Line Electronic User Site Maintenance General Line EPiCS General Line Claims Unit General Line Registration of new practitioners Registration of laboratory and x-ray facilities Locum tenens registration Electronic funds transfers Physician cheque enquiry (opt-in) Claim form information/supplies By Report form Claim Query forms to be used for queries and re-submission of electronic and paper claims Physician Change of Address form, envelopes, etc. Facility Numbers (Hospital and Personal Care Homes) New electronic site set up Deletion of obsolete site Testing for electronic billing Vendor software changes (Electronic Practitioner Integrated Claims Submission) FOB holder, set up, delete and changes Tariff number information Diagnostic code information Incomplete claim enquires Medical data requirements for electronic billing Claims pending for edits 71 Claims pending as received and in progress 74 Claims pending for eligibility pending 72 Claims Unit Physician Enquires on paid, reduced or rejected claims General Line Claims pending for assessment 73, 997, 998 Registration/Client Services General Line Patient Enquiry General Line Audit and Investigation General Line New registration and status changes Out-of-province temporary absences or permanent moves Patient/physician requiring information on eye exams, chiropractic or insured services Applications for dental, cosmetic/plastic surgery Confidential fraud line Out-of-Province Unit Out of Country Medical and Hospital Claims General Line Out of Province Referrals ext 7303 Transportation Subsidy Program for approved out of province referrals Third Party Liability Unit responsible for recovery of health services when a Manitoba resident is injured and initiates a legal or insurance claim against a third party April

4 NEW CLAIMS PROCESSING SOLUTION (CPS) Health, Healthy Living and Seniors is undertaking a project to replace the current billing system used to process provider claims. The new CPS will allow more efficient processing by adjudicating more claims electronically, while maintaining the security of provincial data. Over the last two months information has been provided to system vendors informing them of the changes that will need to be made to their billing systems. As well, a February Special Edition Practitioner s Newsletter was issued to provider groups, including physicians, oral/maxillofacial surgeons, nurse practitioners, optometrists and chiropractors. The new CPS is currently undergoing final development and testing. The new system is anticipated to be operational in the fall of A number of factors will determine the final go-live date, including feedback from providers. Updates will be provided to you respecting the timeframes over the coming months. Please note: More information on the new CPS, including changes to claims submission that you and your billing staff will need to be aware of in order to submit claims, is available at the following link: 4 April 2014

5 CLAIMS UNIT ELECTRONIC USER SITES REMITTANCE DOWNLOAD INSTRUCTIONS All electronic user sites are responsible for downloading their remittance advice twice monthly. The remittance file corresponds to the payment dates of the 15 th of the month and the last day of the month, every month. The first day that a remittance advice is available is 2 working days after the cut-off dates listed on the message screen. The message screen will say which remittance advice is available at any given time for each specific user site at logon. Even if you have not submitted for a specific pay period, check to ensure that there is not a remittance advice to download that could contain the payment reconciliation of claims pending on previous pay periods or adjustments based on query results. Manitoba Health, Healthy Living and Seniors receives a large number of calls regarding missed downloads and user sites requiring recreates for multiple months. MHHLS policy will allow every user 1 recreate free of charge per year. Subsequent requests will result in a $300 fee for each payment recreate requested. If you are missing more than one remittance advice and require recreates for those pay periods, please call the Claims Unit at , or to inquire about additional recreates. If you have any questions regarding Download specifications please review the Electronic Claims Program User Guide available through the EPiCS system online or call our Helpdesk for specific questions at If you are going to be away from your office for a period of time, please notify the Helpdesk in advance and arrangements can be made to send you the remittance advice for those pay periods for reconciliation purposes upon your return so that recreates can be avoided. ICD CODES A reminder regarding ICD codes: Three-digit ICD-9-CM codes are used to identify a condition or disease only when a fourth-digit is not available. Claims submitted with a three-digit ICD code where a fourth-digit is available will be sent back as incompletes requesting the 4th digit. If you do not have access to the ICD-9-CM book and would like a list of the three-digit ICD codes, please call, the Claims Unit at If you wish to obtain the entire ICD-9-CM book, it is available at: HSC Book Store Phone: , Fax: U of M Bookstore, Fort Garry Campus Phone: , Fax: INCOMPLETE CLAIMS Claims are returned Incomplete where additional information is required in order for the claim to be processed. Electronic claims returned as Incomplete with pending code 40 must be re-submitted within 6 months via a new claim with remarks indicating the statement date the original claim was returned to your office. Paper claims returned Incomplete must be returned to our office with the required additional information. For further information regarding Incomplete paper claims contact the Claims Unit at April

6 INTEREST RATES JANUARY 1, 2014 Electronic claims not paid within 30 days of receipt or paper claims not paid within 60 days of receipt, are paid interest on the outstanding amount of the claim until the date of the actual payment. The interest is paid at the prime lending rate plus 1%. This rate is adjusted on January 1 st and July 1 st of each year. Effective January 1, 2014 the prime lending rate was set at 3%. Claims eligible for interest will be calculated at 3% (prime rate) plus 1% for a total of 4%. Claims that span two (2) interest periods will be paid at the current interest rate at the time of payment for the claim. E.g. Interest owed for November, December, January and February - Calculation will be based on the rate that is in effect for February. RE-SUBMISSIONS Query forms must be sent for the following disposal codes: 03, 04, 05, 08, 09, 10, 11, 12, 17, 19, 20, 21, 22, 23, 24, 25, 26, 28, 30, 31, 32, 33, 34, 38, 39, 50, 51, 53, 54, 55, 56. The following disposal codes must be re-submitted via a new claim: 01, 06, 15, 16, 18, 40, 44. Re-submitting claims When re-submitting claims that have been returned disposal code 40 or 44, please include remarks indicating the remittance advice statement date the claim was returned (eg. claim returned incomplete on September 15, 2013 remittance statement). Services submitted as x 2 but only paid x 1 must be queried via query form. If you have any questions regarding the submissions of queries please call the Claims Unit at DISPOSAL CODE 44 Claims which do not include sociological data that matches Manitoba Health, Healthy Living and Seniors (MHHLS) registration database will be automatically rejected with Disposal code 44. The sociological data which must match MHHLS registration database is: 6 digit MHHLS number surname given name date of birth sex Claims that are rejected for incorrect sociological data should be changed and resubmitted electronically. Please do not query. Claims that are rejected for incorrect sociological data should be changed and resubmitted. If you are resubmitting, and the original service date is after 6 months from the date you are resubmitting, MHHLS requires the statement date that the claim was originally returned disposal 44. This date can be printed in the remarks section of an electronic submission. Unless a remark of such is indicated, and all sociological information is correct the second time around, the resubmitted claim may be returned disposal 23 Claim received after 6 (six) months from date of service claim rejected. 6 April 2014

7 MHHLS will continue to assist physicians in obtaining accurate sociological data on their patients, in one of two ways. 1. Access to ireg, MHHLS Insurance Registry, is available to all Manitoba physicians. This application allows the physician or billing staff to verify sociological data for their patients, prior to submitting their claims. To apply for ireg, please call or If you require information on patient eligibility, complete a 529 form Request for MHHLS Registration Number. A supply of these forms may be obtained by calling The completed form may be faxed to MHHLS at , toll free at , or mailed to 300 Carlton Street, Winnipeg, Manitoba R3B 3M9. MHHLS staff will endeavor to complete/correct the data that has been included on the form, and will thereafter fax or mail the information to you. TIMELINE FOR SUBMISSION OF CLAIMS Physicians and billing staff should be aware that the deadline for submission of claims to Manitoba Health, Healthy Living and Seniors is six months from the date of service. The Physician s Manual along with The Health Services Insurance Act states in part: 4(2) A Medical practitioner who provides an insured medical service to an insured person, who has not made an election under subsection 91(1) of the Act, shall submit to the minister. (a) a claim for the service within six months from the date on which the service was provided in the form and manner required by the minister; and (b) such further information respecting the service in a form as may be required by the minister. 4(3) the minister may extend the time limit referred to in subsection (2) if in the minister s opinion there are extenuating circumstances that prevented the filing of the claim within six month period. This six month time requirement may be waived under exceptional circumstances. Late claims are reviewed on a case-by-case basis. The following are examples of situations that may result in the time frame being extended: disasters (fire/flood), fraud, theft of computer or patient files, major computer problems and claims refused by Workers' Compensation Board. Extensions beyond six months are generally not granted for lost/not billed or misplaced claims. Requests for claims submission beyond the six month time frame should be sent by letter to Claims Unit Manager, Insured Benefits, Manitoba Health, Healthy Living and Seniors, 3 rd Floor, 300 Carlton Street, Winnipeg, MB R3B 3M9. Your letter should outline the extenuating circumstances and include a contact phone number where you can be reached. All physicians are encouraged to submit weekly or at more frequent intervals to avoid late claim submissions. TIMELINE FOR SUBMISSION OF QUERIES The timeline for submission of queries on processed (paid/rejected or reduced) claims is six months from the payment or rejection date. Where a claim is submitted with multiple tariff items, some or all of these tariffs may be paid on any one remittance advice. Claims where individual tariffs have been processed may still have items that are pending. Before sending in queries regarding unprocessed tariff(s), be sure to check your pending items. Tariffs which appear pending (71, 72, 73, 74, 997, 998) should not be queried or resubmitted. Processing of these tariff(s) will appear on subsequent statements. Claims that do not appear on your remittance advice and are within six months from the service date can be submitted via a new claim. April

8 Where a claim is pending for three months or longer, and you wish to ascertain the status of the claim, please call the Claims Unit at or Queries should be submitted on the appropriate query form with all areas completed in full including Mantitoba Health, Healthy Living and Seniors registration number, patient sociological data, doctor number, user number, microfilm number, remittance advice date, service date(s), etc. Queries received outside of the above timeline will not be reviewed. If you have any questions regarding the submission of queries please call the Claims Unit at NEW CHRONIC DISEASE MANAGEMENT (CDM) TARIFFS Submission of Patient Care Treatment Forms by Fax: This is to notify you of important information regarding the status of the current fax option for physicians submitting the Patient Care Treatment Form as part of fulfilling the requirements for claiming the CDM tariffs for Diabetes, Congestive Heart Failure, Coronary Artery Disease and Hypertension. Manitoba Health, Healthy Living and Seniors (MHHLS) has been advised that the service provider for the faxing solution is winding down this line of business and will no longer be able to continue to support the current fax service beyond August After August 2014, the following remain as acceptable options for general practitioners in fulfilling the requirements for billing tariffs 8431, 8433, 8434 and 8535: 1. Mail: Paper copies of the completed Patient Care Treatment Forms can be mailed to the Claims Unit at 300 Carlton Street. 2. Drop off: Paper copies of the completed Patient Care Treatment Forms may be dropped off at 300 Carlton Street. 3. Completion of the eform: The eforms can be completed on-line and electronically submitted directly to a secure government repository. The eform can be found at: 4. EMR data extract: General practitioners using a Manitoba-approved Electronic Medical Record (EMR) system may have the option of submitting the supporting information through a quarterly data extract from their EMR, rather than completing the Patient Care Treatment Form to substantiate their claim. This option is available to PIN sites and other sites that have met the criteria for electronic submission and been informed of this by Manitoba Health, Healthy Living and Seniors. For additional information regarding this option, please contact Katie Dyck at (204) or by at kdyck10@manitoba-ehealth.ca. Physicians are reminded that CDM tariffs are payable only to the general practice physician who has provided the majority of the patient s ongoing comprehensive care, in relation to the management of the chronic disease, for the preceding twelve (12) months. 8 April 2014

9 MIDWIFERY REFERRALS AND PROVIDER NUMBER Midwifery has been a regulated profession in Manitoba since June 12, Midwives have the ability to refer their clients for lab & x-ray tests as well as consultations with Physicians. In the past, billing number 3993 (Midwifery) was entered in the referring doctor field as a generic identifier on lab & x-ray claims. The same number was used on claims billed by Physicians for services such as the Midwifery Assessment and Report (tariff 8416) and Telephone/Facsimile/ Communications (tariff 8000) when the referring provider was a Midwife. Midwives are now registered by Manitoba Health, Healthy Living and Seniors, Practitioner Registry with unique provider numbers. The Midwife s unique provider number should now be entered in the referring doctor field for any applicable physician billing (i.e. tariff 8416, lab claims, etc.). Use of the generic billing number 3993 will be discontinued. NEW SIS TO WEBLINK CONVERSION In the next few months Manitoba Health, Healthy Living and Seniors is transitioning users who log in to the EPiCS system through the SIS portal to the new WebLink portal. The change from SIS to WebLink is an upgrade to an online application and does not require any new hardware. The functionality and view is almost identical to the SIS portal. Preliminary notifications are going out by letter to sites that have been identified for conversion. Letter distribution will be followed by a phone call from Manitoba Health, Healthy Living and Seniors staff to validate your information and schedule your conversion. If you or your billing staff have any questions, please contact Irene Trudeau at Thanking you in advance for your co-operation during this transition. LAB SERVICES FOR NORTHERN ONTARIO RESIDENTS Manitoba Health, Healthy Living and Seniors has been advised by OHIP that effective August 1, 2013, Manitoba physicians authorized to order lab services in Manitoba will now be able to order lab services in Ontario for Northern Ontario patients (Kenora and surrounding areas) without requiring an Ontario physician sign the requisition form. All requests must be submitted on an Ontario laboratory requisition form which can be found on Ontario's website at: Any questions concerning this process may be directed to Ontario at interprovincebilling.moh@ontario.ca April

10 REQUEST FOR PRIOR APPROVAL FORM In consideration of the new Claims Processing Solution (CPS) and the requirement for the PHIN, Manitoba Health, Healthy Living and Seniors has revised the Request for Prior Approval form to include the PHIN on this document. Please start using the attached form immediately. Feel free to make copies of the form contained on the next page of this newsletter for your use or contact us at for an electronic copy. The completed form can be sent to: Patient Enquiry Manitoba Health, Healthy Living and Seniors 3 rd floor, 300 Carlton Street Winnipeg, MB R3B 3M9 Fax: April 2014

11 April

12 OUT-OF-PROVINCE UNIT RECIPROCAL BILLING Reciprocal billing agreements between the provinces (except for Quebec) allow physicians to submit claims to Manitoba Health, Healthy Living and Seniors (MHHLS) for most services provided to out-of-province patients. This includes services rendered in the ER, OPD or In-patient department of a hospital and in private offices (except for certain excluded and in-hospital diagnostic services as noted below). Therefore you should submit your accounts for insured services provided to any Canadian resident (except for patients from Quebec) to MHHLS for processing at Manitoba rates. Carefully check the patient s health care card to ensure that their coverage has not expired, as some provinces issue renewable rather than lifetime registration numbers. If a patient does not present a valid health care card, the patient can be considered uninsured and billed directly for all services. The patient may then seek reimbursement from their private insurer or, if they have valid coverage, their home province s insurance plan. Quebec does not participate in the inter-provincial reciprocal medical billing agreements. If you treat a Quebec resident, your physician billing options are as follows: Bill the Quebec resident directly. The resident can then seek reimbursement from the Quebec Health Plan; or Bill the The Régie de l'assurance maladie (contact information can be found at You will be paid the applicable Quebec rates for the services rendered. You will also need to ensure that the Quebec resident s health care card is valid. 12 April 2014

13 PRACTITIONER REGISTRY CHANGE OF ELECTRONIC USER SITE Practitioners changing and/or leaving an Electronic User Site should notify Manitoba Health, Healthy Living and Seniors (MHHLS) in writing specifying the date they will be leaving practice at that location. Please be sure to include your name, billing number, user site number and the effective date. Once this information is received, MHHLS will adjust your profile to reflect the corrected information. When beginning at a new practice location, practitioners should complete a Letter of Agreement form. The Letter of Agreement allows MHHLS to link the practitioner s billing number with the new user site number so claims will be accepted electronically by MHHLS. Fee-for-Service practitioners should complete an Electronic Funds Transfer form. The Electronic Funds Transfer form allows MHHLS to direct the funds generated through the submission of claims at that location to a bank account of your choice. Claims should not be submitted before these completed forms are sent to MHHLS. To request forms, obtain additional information or submit correspondence regarding any of the above changes please contact Practitioner Registry at: Practitioner Registry Manitoba Health, Healthy Living and Seniors 3 rd Floor, 300 Carlton Street Winnipeg, Manitoba R3B 3M9 Phone: Fax: practitionerregistry@gov.mb.ca CHANGE OF SOFTWARE VENDOR Practitioners changing Software Vendors must notify Manitoba Health, Healthy Living and Seniors (MHHLS) in writing. Be sure to indicate that you are changing software vendors, include your current user number and projected conversion dates. Please indicate that your intent is to close your old user site number once all claims and queries have been cleared. You will need to complete and submit several forms to MHHLS in order to apply for a new Electronic User Number. A test submission is also required. Your new user site number will not be activated until you have passed the testing process. Please contact Practitioner Registry for additional details and to request the required forms: Practitioner Registry Manitoba Health, Healthy Living and Seniors 3 rd Floor, 300 Carlton Street Winnipeg, MB R3B 3M9 Phone: Fax: practitionerregistry@gov.mb.ca April

14 CHANGE OF MAILING ADDRESS Practitioners changing their mailing address should notify Manitoba Health, Healthy Living and Seniors of the change in writing at least two weeks prior to moving, or leaving the province. This will allow sufficient time to make the necessary changes; in turn ensuring future payments or correspondence is forwarded to the proper address. Please contact us by mail: Practitioner Registry Manitoba Health, Healthy Living and Seniors 3 rd Floor, 300 Carlton Street Winnipeg, MB R3B 3M9 practitionerregistry@gov.mb.ca CHANGING OR CLOSING BANK ACCOUNT Please notify Practitioner Registry, Manitoba Health, Healthy Living and Seniors at of all banking changes to ensure that your financial records are updated. IMPORTANT MESSAGE FOR MANITOBA PHYSICIANS REGARDING INSURANCE REGISTRY (IREG) RELEASE Pursuant to the Master Agreement between Manitoba Health, Healthy Living and Seniors & Doctors Manitoba, we are pleased to offer ireg (Insurance Registry) access to Manitoba physicians who currently submit claims using the EPiCS (Electronic Practitioner integrated Claim Submission) system. The Master Agreement states the following: 12:01 The parties acknowledge and agree that Manitoba Health has committed to provide Manitoba physicians that have EPiCS infrastructure in their office(s) with access to the Insurance Registry ( ireg ). Implementation will commence December 1, Thereafter, Manitoba Health will release ireg access to applicants over a six to twelve month period. You will see an icon when logging into the SIS (EPiCS) portal ireg release package. This is a PDF document which contains all the necessary paperwork in order to apply for ireg. Don t wait. Apply now. Access will be granted on a first-in, first-out basis and will be rolled out during the next several months in accordance with the Master Agreement. For additional information please call the Claims Unit at or April 2014

15 THIRD PARTY CLAIMS WORKERS COMPENSATION BOARD (WCB) BILLINGS Manitoba Health, Healthy Living and Seniors (MHHLS) has been receiving billings from physicians providing medical services to patients who have sustained injuries or illness as a result of their employment for which they are covered by Workers Compensation Board. Physicians are reminded that the following services are not insured by MHHLS as set out in the Excluded Services Regulation under The Health Services Insurance Act. Exclusions The following services are not insured services: Services for any illness, injury or condition arising out of or in the course of employment and for which the indemnity is received under workers compensation law, occupational disease law or similar legislation. In those instances where the physician is treating a patient for a work-related injury or illness, but is not certain of WCB liability, it is recommended that the initial billing be made to WCB. Should the Board deny responsibility for the case, the claim may be redirected to MHHLS with a notation indicating WCB rejection. In cases where a WCB claim has been paid by MHHLS and subsequently paid by WCB, the request to withdraw MHHLS payment must be submitted via query form. April

16 PHYSICIAN S MANUAL UPDATES Updates to the Physician s Manual are available on the Manitoba Health, Healthy Living and Seniors website for viewing and downloading. Visit the site at The site will be updated quarterly, January 1 st, April 1 st, July 1 st and October 1 st of each year. Comments or questions about the manual may be directed to manual@gov.mb.ca 16 April 2014

17 APPEND IX IMPORTANT DATES FOR 2014 HOLIDAY CLOSURES Manitoba Health, Healthy Living and Seniors offices will be closed on the following dates: January 1, 2014 February 17, 2014 April 18, 2014 April 21, 2014 May 19, 2014 July 1, 2014 August 4, 2014 September 1, 2014 October 13, 2014 November 11, 2014 December 25, 2014 December 26, 2014 FEE FOR SERVICE MAILING DATES Paper cheques for fee for service practitioner payments are mailed on the following dates: January 14, 2014 July 14, 2014 January 30, 2014 July 30, 2014 February 14, 2014 August 14, 2014 February 27, 2014 August 29, 2014 March 14, 2014 September 12, 2014 March 28, 2014 September 29, 2014 April 14, 2014 October 14, 2014 April 29, 2014 October 30, 2014 May 14, 2014 November 14, 2014 May 30, 2014 November 28, 2014 June 13, 2014 December 12, 2014 June 27, 2014 December 30, 2014 April

18 MANITOBA HEALTH, HEALTHY LIVING AND SENIORS 2014 CUT-OFF DATES FOR ELECTRONIC CLAIMS PAY PERIODS JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER 12 EPiCS EPiCS cut-offs are at 5:00 P.M. Check the message screen in case of changes. 30 Manitoba Health, Healthy Living and Seniors strongly recommends you submit claims frequently (no less than once per week) to reduce your risk of missing a payment cycle. Always check the audit control confirmation report (P1) the next business day to verify acceptance of files. Acceptance of the file does not guarantee payment for the claims submitted as all claims received must still follow normal processing channels and rules. Questions or concerns? Please contact: ELECTRONIC SUPPORT at April 2014

19 April

20 20 April 2014

21 April

22 22 April 2014

23 April

24 24 April 2014

25 April

26 26 April 2014

27 April

28 28 April 2014

29 April

PRACTITIONER REGISTRY/USER SITE MAINTENANCE CLAIMS UNIT CLAIMS ENQUIRY. 204-788-2567 or 204-786-7225 Email: practitionerregistry@gov.mb.

PRACTITIONER REGISTRY/USER SITE MAINTENANCE CLAIMS UNIT CLAIMS ENQUIRY. 204-788-2567 or 204-786-7225 Email: practitionerregistry@gov.mb. Contact Information CONTACT INFORMATION PRACTITIONER REGISTRY/USER SITE MAINTENANCE 204-788-2567 or 204-786-7225 Email: practitionerregistry@gov.mb.ca Practitioner Registry staff at Manitoba Health, Healthy

More information

Alberta Health Physician s Resource Guide

Alberta Health Physician s Resource Guide Alberta Health Physician s Resource Guide For use by physicians and their office staff as a guide for handling fee-for-service claims to the Alberta Health Care Insurance Plan June 2014 The Physician s

More information

Ontario Hospital Association/Ontario Medical Association Hospital Prototype Board-Appointed Professional Staff By-law

Ontario Hospital Association/Ontario Medical Association Hospital Prototype Board-Appointed Professional Staff By-law Ontario Hospital Association/Ontario Medical Association Hospital Prototype Board-Appointed Professional Staff By-law 2011 ONTARIO HOSPITAL ASSOCIATION/ ONTARIO MEDICAL ASSOCIATION HOSPITAL PROTOTYPE BOARD-APPOINTED

More information

Alberta Health Care Insurance Plan Essential Information for Albertans

Alberta Health Care Insurance Plan Essential Information for Albertans Essential Information for Albertans The Alberta Health Care provides eligible residents of Alberta and their dependants with: coverage for insured services provided by physicians in Alberta and in other

More information

Hospital and Medical Services Insurance on Prince Edward Island. Benefits Eligibility Out of Province Coverage

Hospital and Medical Services Insurance on Prince Edward Island. Benefits Eligibility Out of Province Coverage Hospital and Medical Services Insurance on Prince Edward Island Benefits Eligibility Out of Province Coverage Table of Contents Introduction...1 What are the PEI Hospital & Medical Services Plans?...1

More information

Policy Terms, Conditions, and Benefits of Insurance

Policy Terms, Conditions, and Benefits of Insurance Policy Terms, Conditions, and Benefits of Insurance FORM HbcTC2008 Please Read Carefully and Attach to Your Document of Insurance TABLE OF CONTENTS I. INSURING AGREEMENT......................................1

More information

Administration Manual Pediatric Insulin Pump Program (PIPP) Policies and Procedures Version 2.0

Administration Manual Pediatric Insulin Pump Program (PIPP) Policies and Procedures Version 2.0 Administration Manual Pediatric Insulin Pump Program (PIPP) Policies and Procedures Version 2.0 Health October 2012 2 Table of Contents SECTION 1: INTRODUCTION... 4 SECTION 2: ROLES AND RESPONSIBILITIES...

More information

Disability Income Protection

Disability Income Protection Disability Income Protection Table of contents Introduction... 1 Highlights...2 Sick Leave plan... 4 Joining the plan...4 Cost...4...4 Exclusions... 5 In the event... 5 How to submit claims... 5 Group

More information

Ratified: June 6, 2013 PROFESSIONAL STAFF BY-LAW

Ratified: June 6, 2013 PROFESSIONAL STAFF BY-LAW Ratified: June 6, 2013 PROFESSIONAL STAFF BY-LAW ARTICLE 1 DEFINITIONS AND INTERPRETATION...4 Section 1.1 Definitions...4 Section 1.2 Interpretation...6 Section 1.3 Delegation of Duties...6 Section 1.4

More information

APPLICATION FOR REGISTRATION:

APPLICATION FOR REGISTRATION: APPLICATION FOR REGISTRATION: POSTGRADUATE EDUCATION - 2015 CANADIAN MEDICAL SCHOOL GRADUATES MATCHED TO AN ONTARIO RESIDENCY PROGRAM Dear Applicant: The College is pleased to provide this application

More information

UC IRVINE 2014-2015 STUDENT HEALTH INSURANCE PLAN FREQUENTLY ASKED QUESTIONS

UC IRVINE 2014-2015 STUDENT HEALTH INSURANCE PLAN FREQUENTLY ASKED QUESTIONS UC IRVINE 2014-2015 STUDENT HEALTH INSURANCE PLAN FREQUENTLY ASKED QUESTIONS I. WELLNESS What is the importance of having health insurance as a student? Medical costs can be overwhelming and are rising

More information

Patient Resource Guide for Billing and Insurance Information

Patient Resource Guide for Billing and Insurance Information Patient Resource Guide for Billing and Insurance Information 17 Patient Account Payment Policies July 2012 Update Lexington Clinic Central Business Office Payment Policies Customer service...2 Check-in...2

More information

Alberta Health Care Insurance Plan Essential Information for Albertans

Alberta Health Care Insurance Plan Essential Information for Albertans Essential Information for Albertans The Alberta Health Care provides eligible residents of Alberta and their dependants with: coverage for insured services provided by physicians in Alberta and in other

More information

Terms and Conditions

Terms and Conditions EMR Adoption Program New EMR Adopter Funding Terms and Conditions PROGRAM PURPOSE. The EMR Adoption Program is intended to increase the number of Ontario physicians who use OntarioMD-certified ( certified

More information

PROCEDURES TO CLAIM SHORT TERM DISABILITY BENEFITS

PROCEDURES TO CLAIM SHORT TERM DISABILITY BENEFITS PROCEDURES TO CLAIM SHORT TERM DISABILITY BENEFITS The Short Term Disability (STD) benefits help you through periods when you are off work due to disability caused by illness or accidental injury outside

More information

UC IRVINE 2014-2015 STUDENT HEALTH INSURANCE PLAN FREQUENTLY ASKED QUESTIONS

UC IRVINE 2014-2015 STUDENT HEALTH INSURANCE PLAN FREQUENTLY ASKED QUESTIONS UC IRVINE 2014-2015 STUDENT HEALTH INSURANCE PLAN FREQUENTLY ASKED QUESTIONS I. WELLNESS What is the importance of having health insurance as a student? Medical costs can be overwhelming and are rising

More information

WC 101 : From Injury to Closure WC Claim Rights & Responsibilities Jennifer Flood, Ombudsman for Injured Workers Lisa Wilch, Claims Director SAIF Corporation Today s Session Claim filing Claim decisions

More information

GTEC 2011. Andrew Yorke President & CEO Manitoba Blue Cross

GTEC 2011. Andrew Yorke President & CEO Manitoba Blue Cross GTEC 2011 1 Andrew Yorke President & CEO Manitoba Blue Cross Background on the Two Strategic Partners Manitoba Insured Benefits Branch Manitoba Blue Cross Joint Claims System Project Scope Timeframes Budget

More information

UC IRVINE 2015-2016 STUDENT HEALTH INSURANCE PLAN FREQUENTLY ASKED QUESTIONS

UC IRVINE 2015-2016 STUDENT HEALTH INSURANCE PLAN FREQUENTLY ASKED QUESTIONS UC IRVINE 2015-2016 STUDENT HEALTH INSURANCE PLAN FREQUENTLY ASKED QUESTIONS I. WELLNESS What is the importance of having health insurance as a student? Medical costs can be overwhelming and are rising

More information

RULES OF TENNESSEE DEPARTMENT OF LABOR DIVISION OF WORKER S COMPENSATION CHAPTER 0800-02-01 GENERAL RULES OF THE WORKERS COMPENSATION PROGRAM

RULES OF TENNESSEE DEPARTMENT OF LABOR DIVISION OF WORKER S COMPENSATION CHAPTER 0800-02-01 GENERAL RULES OF THE WORKERS COMPENSATION PROGRAM RULES OF TENNESSEE DEPARTMENT OF LABOR DIVISION OF WORKER S COMPENSATION CHAPTER 0800-02-01 GENERAL RULES OF THE WORKERS COMPENSATION PROGRAM TABLE OF CONTENTS 0800-02-01-.01 Purpose and Scope 0800-02-01-.15

More information

CHAPTER 59A-23 WORKERS COMPENSATION MANAGED CARE ARRANGEMENTS 59A-23.001 Scope. 59A-23.002 Definitions. 59A-23.003 Authorization Procedures.

CHAPTER 59A-23 WORKERS COMPENSATION MANAGED CARE ARRANGEMENTS 59A-23.001 Scope. 59A-23.002 Definitions. 59A-23.003 Authorization Procedures. CHAPTER 59A-23 WORKERS COMPENSATION MANAGED CARE ARRANGEMENTS 59A-23.001 Scope. 59A-23.002 Definitions. 59A-23.003 Authorization Procedures. 59A-23.004 Quality Assurance. 59A-23.005 Medical Records and

More information

California Workers Compensation Medical Provider Network Employee Notification & Guide

California Workers Compensation Medical Provider Network Employee Notification & Guide California Workers Compensation Medical Provider Network Employee Notification & Guide In partnership with We are pleased to introduce the California workers compensation medical provider network (MPN)

More information

Molina Healthcare of Ohio, Inc. PO Box 22712 Long Beach, CA 90801

Molina Healthcare of Ohio, Inc. PO Box 22712 Long Beach, CA 90801 Section 9. Claims As a contracted provider, it is important to understand how the claims process works to avoid delays in processing your claims. The following items are covered in this section for your

More information

2014 Member s Annual Statement

2014 Member s Annual Statement 2014 Member s Annual Statement 3sHealth continually strives to find new and better ways to serve Employee Benefit Plan Members. We hope you find the information in this year s Member s Annual Statement

More information

Resource Manual for Physicians. Ministry of Health and Long-Term Care

Resource Manual for Physicians. Ministry of Health and Long-Term Care Ministry of Health and Long-Term Care Version 1.0 February 2014 Resource Manual for Physicians This manual is a general summary provided for information purposes only. All efforts are made to ensure the

More information

MEDICAL STAFF BYLAWS FOR CHILDREN'S & WOMEN'S HEALTH CENTRE OF BRITISH COLUMBIA AN AGENCY OF THE PROVINICAL HEALTH SERVICES AUTHORITY

MEDICAL STAFF BYLAWS FOR CHILDREN'S & WOMEN'S HEALTH CENTRE OF BRITISH COLUMBIA AN AGENCY OF THE PROVINICAL HEALTH SERVICES AUTHORITY MEDICAL STAFF BYLAWS FOR CHILDREN'S & WOMEN'S HEALTH CENTRE OF BRITISH COLUMBIA AN AGENCY OF THE PROVINICAL HEALTH SERVICES AUTHORITY SEPTEMBER 1, 2004 Board Approved June 24, 2004 Ministry of Health Approved

More information

Title 40. Labor and Employment. Part 1. Workers' Compensation Administration

Title 40. Labor and Employment. Part 1. Workers' Compensation Administration Title 40 Labor and Employment Part 1. Workers' Compensation Administration Chapter 3. Electronic Billing 301. Purpose The purpose of this Rule is to provide a legal framework for electronic billing, processing,

More information

PREDESIGNATION OF PERSONAL PHYSICIANS AND REPORTING DUTIES OF THE PRIMARY TREATING PHYSICIAN REGULATIONS

PREDESIGNATION OF PERSONAL PHYSICIANS AND REPORTING DUTIES OF THE PRIMARY TREATING PHYSICIAN REGULATIONS PREDESIGNATION OF PERSONAL PHYSICIANS AND REPORTING DUTIES OF THE PRIMARY TREATING PHYSICIAN REGULATIONS Title 8, California Code of Regulations Chapter 4.5. Division of Workers Compensation Subchapter

More information

Understanding Group Health Insurance Anthem KeyCare 15+ Plan

Understanding Group Health Insurance Anthem KeyCare 15+ Plan Understanding Group Health Insurance Anthem KeyCare 15+ Plan January 12, 2010 Although it is the intent of the University to continue current benefit plans, the University reserves the right to modify,

More information

BIRMINGHAM CITY UNIVERSITY ACADEMIES TRUST SICK PAY AND ABSENCE MANAGEMENT SCHEME

BIRMINGHAM CITY UNIVERSITY ACADEMIES TRUST SICK PAY AND ABSENCE MANAGEMENT SCHEME BIRMINGHAM CITY UNIVERSITY ACADEMIES TRUST SICK PAY AND ABSENCE MANAGEMENT SCHEME 1. Introduction 1.1. BCUAT wants to ensure that employees who are absent from work due to ill-health or injury receive

More information

(d) Concurrent review means utilization review conducted during an inpatient stay.

(d) Concurrent review means utilization review conducted during an inpatient stay. 9792.6. Utilization Review Standards Definitions For Utilization Review Decisions Issued Prior to July 1, 2013 for Injuries Occurring Prior to January 1, 2013. As used in this Article: The following definitions

More information

Plan Member Privacy Information Package

Plan Member Privacy Information Package Plan Member Privacy Information Package This Privacy Information Package was developed to help you, as a group plan member, understand why Manulife s Group Benefits collects your personal information,

More information

Reference Guide. Chiropractic Services Memorandum of Agreement. Date September 2014. Health Care Services. Prepared by

Reference Guide. Chiropractic Services Memorandum of Agreement. Date September 2014. Health Care Services. Prepared by Reference Guide Chiropractic Services Memorandum of Agreement Department Health Care Services Date Prepared by Health Care Services Phone: 604.232.7787 or 1.888.967.5377 (Local 7787) E-mail: HCSINQU@worksafebc.com

More information

Workers Compensation and Disability Administration. Short-Term Disability Insurance (VDI) and Paid Family Leave (PFL)

Workers Compensation and Disability Administration. Short-Term Disability Insurance (VDI) and Paid Family Leave (PFL) Workers Compensation and Disability Administration Short-Term Disability Insurance (VDI) and Paid Family Leave (PFL) January 1, 2013 To: From: Re: Faculty and Staff of The Claremont Colleges Workers Compensation

More information

CIBC Mortgage Disability Insurance and CIBC Mortgage Disability Insurance Plus

CIBC Mortgage Disability Insurance and CIBC Mortgage Disability Insurance Plus Page 1 of 5 CIBC Mortgage Disability Insurance and CIBC Mortgage Disability Insurance Plus Your Certificate Of Insurance CIBC Mortgage Disability Insurance ( Mortgage Disability Insurance ) and CIBC Mortgage

More information

Interprofessional Team Demonstration Initiative

Interprofessional Team Demonstration Initiative Interprofessional Team Demonstration Initiative Data and Measurement FAQs The Interprofessional Team Demonstration Initiative requires good data management and measurement to inform payment and evaluation.

More information

Section 9. Claims Claim Submission Molina Healthcare PO Box 22815 Long Beach, CA 90801

Section 9. Claims Claim Submission Molina Healthcare PO Box 22815 Long Beach, CA 90801 Section 9. Claims As a contracted provider, it is important to understand how the claims process works to avoid delays in processing your claims. The following items are covered in this section for your

More information

Alberta Health. Allied Health Practitioner s Resource Guide

Alberta Health. Allied Health Practitioner s Resource Guide Alberta Health Allied Health Practitioner s Resource Guide For use by allied health practitioners and their office staff as a guide for handling fee-for-service claims to the Alberta Health Care Insurance

More information

10. CLAIMS PROCESSING

10. CLAIMS PROCESSING 10. CLAIMS PROCESSING This section outlines details of the claims payment process and related matters. 10.1 TIME LIMITS Claims must be submitted within 90 days from the date services are completed. However,

More information

Flexible Spending Account (FSA) / Dependent Care Account (DCA)

Flexible Spending Account (FSA) / Dependent Care Account (DCA) Flexible Spending Account (FSA) / Dependent Care Account (DCA) University Medical Associates PLAN YEAR: 1/1/15 12/31/15 You have 90 days at the end of the Plan to file claims for services provided during

More information

Frequently Asked Questions. The term lost time injury means a non-fatal injury that causes any loss of time from work.

Frequently Asked Questions. The term lost time injury means a non-fatal injury that causes any loss of time from work. Frequently Asked Questions 1. What is a lost time injury? The term lost time injury means a non-fatal injury that causes any loss of time from work. 2. What is Continuation of Pay (COP) and when does it

More information

HOW DO I PARTICIPATE IN ACCESS GAP COVER? HOW DO I CLAIM? Complete the Provider Details & Direct Credit Authority form.

HOW DO I PARTICIPATE IN ACCESS GAP COVER? HOW DO I CLAIM? Complete the Provider Details & Direct Credit Authority form. 1 HOW DO I PARTICIPATE IN ACCESS GAP COVER? HOW DO I CLAIM? Complete the Provider Details & Direct Credit Authority form. (Attachments 3and 3A) Identify patient as a member of an AHSA Participating Fund

More information

CANADIAN PAYMENTS ASSOCIATION ASSOCIATION CANADIENNE DES PAIEMENTS RULE F1 RULES APPLICABLE TO AUTOMATED FUNDS TRANSFER (AFT) TRANSACTIONS

CANADIAN PAYMENTS ASSOCIATION ASSOCIATION CANADIENNE DES PAIEMENTS RULE F1 RULES APPLICABLE TO AUTOMATED FUNDS TRANSFER (AFT) TRANSACTIONS CANADIAN PAYMENTS ASSOCIATION ASSOCIATION CANADIENNE DES PAIEMENTS RULE F1 RULES APPLICABLE TO AUTOMATED FUNDS TRANSFER (AFT) TRANSACTIONS 2015 CANADIAN PAYMENTS ASSOCIATION 2015 ASSOCIATION CANADIENNE

More information

Canadian Public / Private Travel Health Insurance - A Consumer s Report

Canadian Public / Private Travel Health Insurance - A Consumer s Report Canadian Public / Private Travel Health Insurance - A Consumer s Report An analysis of information obtained from response to a survey on Travel Health Insurance sent to Provincial Ministers of Health in

More information

OSHR Workers Compensation Settlement Reserve Funds Allocations Beginning July 1, 2016. Administration Process Pages 2-5

OSHR Workers Compensation Settlement Reserve Funds Allocations Beginning July 1, 2016. Administration Process Pages 2-5 OSHR Workers Compensation Settlement Reserve Funds Allocations Beginning July 1, 2016 Administration Process Pages 2-5 Agency Application Form Page 6 Instructions for Completion of Agency Application Form

More information

Coventry receives claims in two ways:

Coventry receives claims in two ways: Coventry receives claims in two ways: Paper Claims Providers send claims to the specific Coventry PO Box, which are keyed by our vendor and sent via an EDI file for upload into IDX. Electronic Claims -

More information

Health Service Provider Licensing Toolkit for Examinations/Audits

Health Service Provider Licensing Toolkit for Examinations/Audits Health Service Provider Licensing Toolkit for Examinations/Audits INTRODUCTION In December 2014, the Financial Services Commission of Ontario (FSCO) began on-site audits which they refer to as examinations

More information

Group Benefits. Emergency Out of Country Coverage

Group Benefits. Emergency Out of Country Coverage Group Benefits Emergency Out of Country Coverage Keep this brochure and a copy of your Emergency Medical Travel Assistance card with your passport so that you or anyone you re travelling with can get assistance

More information

Compliance Document for Kalamazoo College, G-1013

Compliance Document for Kalamazoo College, G-1013 Compliance Document for Kalamazoo College, G-1013 Employers sponsoring a group health plan are required by law to provide certain notices to individuals within a set time frame. ASR Health Benefits is

More information

Handbook for Providers of Therapy Services

Handbook for Providers of Therapy Services Handbook for Providers of Therapy Services Chapter J-200 Policy and Procedures For Therapy Services Illinois Department of Healthcare and Family Services CHAPTER J-200 THERAPY SERVICES TABLE OF CONTENTS

More information

How To Get A Workers Compensation Check In The United States

How To Get A Workers Compensation Check In The United States New Hire Notice -- Injuries Caused By Work What does workers compensation cover? You may be entitled to workers' compensation benefits if you are injured or become ill because of your job. Workers' compensation

More information

ABSOLUTE HEALTH HEALTH INSURANCE POLICY TABLE OF CONTENTS. 1 What are your policy benefits 2. 2 Your premiums 2. 3 How to make a claim 2

ABSOLUTE HEALTH HEALTH INSURANCE POLICY TABLE OF CONTENTS. 1 What are your policy benefits 2. 2 Your premiums 2. 3 How to make a claim 2 HEALTH INSURANCE POLICY ABSOLUTE HEALTH TABLE OF CONTENTS 1 What are your policy benefits 2 2 Your premiums 2 > > Premium > > Method of paying premiums > > What happens if you do not pay the premium on

More information

Green Shield Canada (GSC) Extended and Individual Travel Health Plans for GMCL Salaried Retirees

Green Shield Canada (GSC) Extended and Individual Travel Health Plans for GMCL Salaried Retirees Green Shield Canada (GSC) Extended and Individual Travel Health Plans for GMCL Salaried s The base travel plan for GMCL Salaried s (who retired on or after January 1, 1995) provides coverage for the first

More information

APPLICABLE TO McCREARY ALONSA, MENNO HOME, ROCK LAKE HEALTH DISTRICT, BETEL HOME FOUNDATION, AND ALL RHAs EXCEPT WINNIPEG

APPLICABLE TO McCREARY ALONSA, MENNO HOME, ROCK LAKE HEALTH DISTRICT, BETEL HOME FOUNDATION, AND ALL RHAs EXCEPT WINNIPEG ARTICLE 13: INCOME PROTECTION Also refer to Article 31 Special Provisions re. Part-time Employees. 1301 An employee who is absent from scheduled work due to illness, disability, quarantine or because of

More information

DISABILITY BENEFITS. An explanation of the salary protection program available to IMRF members. Locally funded, financially sound.

DISABILITY BENEFITS. An explanation of the salary protection program available to IMRF members. Locally funded, financially sound. DISABILITY BENEFITS An explanation of the salary protection program available to IMRF members. 02/2015 Locally funded, financially sound. YOUR IMRF DISABILITY CHECKLIST Please use this checklist when

More information

Clinical Optimization

Clinical Optimization Clinical Optimization Learning Objectives Uses of the Alt Key User Preferences to customize Accuro for you Home Section Tips Shortcut Keys and their functions Virtual Chart tips Use of the ALT Key Alt+

More information

Frequently Asked Questions (FAQ) NWT Health Care Card Renewal

Frequently Asked Questions (FAQ) NWT Health Care Card Renewal Frequently Asked Questions (FAQ) NWT Health Care Card Renewal Q1: Why do I need a Health Care Card? Q2: Why do Health Care Cards expire? Q3: When does my NWT Health Care Card expire? Q4: Where do I get

More information

MEDICAL SERVICES COMMISSION OUT OF PROVINCE AND OUT OF COUNTRY MEDICAL CARE GUIDELINES

MEDICAL SERVICES COMMISSION OUT OF PROVINCE AND OUT OF COUNTRY MEDICAL CARE GUIDELINES MEDICAL SERVICES COMMISSION OUT OF PROVINCE AND OUT OF COUNTRY MEDICAL CARE GUIDELINES A. PREAMBLE The primary purpose of the Medicare Protection Act is "to preserve a publicly managed and fiscally sustainable

More information

Summary of Union Offer for Settlement August 31, 2011 (complete with prejudice offer attached)

Summary of Union Offer for Settlement August 31, 2011 (complete with prejudice offer attached) Summary of Union Offer for Settlement August 31, 2011 (complete with prejudice offer attached) Summary Wages 2 year agreement Year 1 3% Year 2-3% Other Provisions Article 1.1 - Requires part-time persons

More information

Handbook for Home Health Agencies

Handbook for Home Health Agencies Handbook for Home Health Agencies Chapter R-200 Policy and Procedures For Home Health Agencies Illinois Department of Public Aid CHAPTER R-200 Home Health Agency Services TABLE OF CONTENTS FOREWORD R-200

More information

J. Richard Lilly, M.D., A.B.F.P., & Associates, P.C.

J. Richard Lilly, M.D., A.B.F.P., & Associates, P.C. J. Richard Lilly, M.D., A.B.F.P., & Associates, P.C. PATIENT REGISTRATION - Please PRINT Clearly Patient Name First Middle Last Date of Birth Age Home Address Apt. No. City State Zip code Occupation Social

More information

Compliance Document for Holland Public Schools, G-768

Compliance Document for Holland Public Schools, G-768 Compliance Document for Holland Public Schools, G-768 Employers sponsoring a group health plan are required by law to provide certain notices to individuals within a set time frame. ASR Health Benefits

More information

REGISTRATION FOR ONTARIO HEALTH INSURANCE COVERAGE

REGISTRATION FOR ONTARIO HEALTH INSURANCE COVERAGE REGISTRATION FOR ONTARIO HEALTH INSURANCE COVERAGE 5 5.1 CLIENT REGISTRATION OVERVIEW... 2 5.2 ELIGIBILITY OVERVIEW... 2 5.3 HEALTH CARDS... 4 Red and White Health Cards... 4 Photo Health Card... 4 Health

More information

User Guide. COBRA Employer Manual

User Guide. COBRA Employer Manual Experience Excellence COBRA Manual User Guide COBRA Employer Manual COBRA Responsibilities and Deadlines Under COBRA, specific notices must be provided to covered employees and their families explaining

More information

1.2 MCP PUBLICATIONS 1.2.1 MCP Dental Payment Schedule 1 8 1.2.2 Newsletters. 2 8 1.2.3 Website... 2 8

1.2 MCP PUBLICATIONS 1.2.1 MCP Dental Payment Schedule 1 8 1.2.2 Newsletters. 2 8 1.2.3 Website... 2 8 Table of Contents 1. INTRODUCTION 1.1 OVERVIEW.. 1 8 1.2 MCP PUBLICATIONS 1.2.1 MCP Dental Payment Schedule 1 8 1.2.2 Newsletters. 2 8 1.2.3 Website.... 2 8 1.3 ROLES & RESPONSIBILITIES 1.3.1 Role of the

More information

NT WORKERS COMPENSATION CLAIM FORM

NT WORKERS COMPENSATION CLAIM FORM Information for Workers Guidance to PART 1 of the Claim Form Notify your employer of your injury, verbally or in writing, as soon as practicable. Fully complete PART 1 (questions 1 to 8) of the following

More information

OHIP Billing Information for Telemedicine Services 1 September 2011

OHIP Billing Information for Telemedicine Services 1 September 2011 1 TABLE OF CONTENTS 1. Overview... 2 2. Registration... 2 3. Billing Information and Requirements... 2 4. Excluded Telemedicine Services Fee Codes... 4 5. Billing Requirements Summary... 5 6. Manual Review...

More information

Certificate of Insurance Creditor Insurance for CIBC Personal Lines of Credit. Note: This is an important document. Please keep it in a safe place.

Certificate of Insurance Creditor Insurance for CIBC Personal Lines of Credit. Note: This is an important document. Please keep it in a safe place. Certificate of Insurance Creditor Insurance for CIBC Personal Lines of Credit Page 1 of 11 Table of Contents Note: This is an important document. Please keep it in a safe place. Introduction...2 Your rights

More information

Independent Bill Review Regulations

Independent Bill Review Regulations Title 8, California Code of Regulations Chapter 4.5 Division of Workers Compensation Subchapter 1 Administrative Director Administrative Rules Article 5.5.0 Rules for Medical Treatment Billing and Payment

More information

University Health Insurance Plan (UHIP ) your basic health care solution

University Health Insurance Plan (UHIP ) your basic health care solution University Health Insurance Plan (UHIP ) your basic health care solution For all eligible international residents studying or working at participating universities in Ontario, Canada. Group Policy Number

More information

1. Employee Benefits: Workers' Compensation provides both medical and indemnity benefit payments for and to eligible employees.

1. Employee Benefits: Workers' Compensation provides both medical and indemnity benefit payments for and to eligible employees. Policies of the University of North Texas Health Science Center 05.803 Worker s Compensation Insurance Chapter 05 Human Resources Policy Statement. The University of North Texas Health Science Center at

More information

9. ALTERNATE BILLING SYSTEM (ABS) ARRANGEMENTS

9. ALTERNATE BILLING SYSTEM (ABS) ARRANGEMENTS 9. ALTERNATE BILLING SYSTEM (ABS) ARRANGEMENTS 9.1 OVERVIEW ABS is an alternative billing arrangement to the fee-for-service claiming system. An ABS arrangement must be requested and performed under the

More information

NC WORKERS COMPENSATION: BASIC INFORMATION FOR MEDICAL PROVIDERS

NC WORKERS COMPENSATION: BASIC INFORMATION FOR MEDICAL PROVIDERS NC WORKERS COMPENSATION: BASIC INFORMATION FOR MEDICAL PROVIDERS CURRENT AS OF APRIL 1, 2010 I. INFORMATION SOURCES Where is information available for medical providers treating patients with injuries/conditions

More information

RULES AND REGULATIONS FOR UTILIZATION REVIEW IN ARKANSAS ARKANSAS DEPARTMENT OF HEALTH

RULES AND REGULATIONS FOR UTILIZATION REVIEW IN ARKANSAS ARKANSAS DEPARTMENT OF HEALTH RULES AND REGULATIONS FOR UTILIZATION REVIEW IN ARKANSAS 2003 ARKANSAS DEPARTMENT OF HEALTH TABLE OF CONTENTS SECTION 1 Authority and Purpose.. 1 SECTION 2 Definitions...2 SECTION 3 Private Review Agents

More information

National Benefit Fund

National Benefit Fund 1199SEIU National Benefit Fund June 2015 SUMMARY PLAN DESCRIPTION Section VI Retiree Health Benefits A. Retiree Health Benefits B. Using Your Benefits Wisely C. If You Retire at or after Age 65 and Live

More information

PROMPT PAYMENT, MANAGED CARE CLAIM BILLING AND COLLECTION ISSUES ERIC D. KATZ, ESQ.

PROMPT PAYMENT, MANAGED CARE CLAIM BILLING AND COLLECTION ISSUES ERIC D. KATZ, ESQ. PROMPT PAYMENT, MANAGED CARE CLAIM BILLING AND COLLECTION ISSUES ERIC D. KATZ, ESQ. 1 1 I. PROMPT PAYMENT UNDER THE Laws equally applicable to pars and non pars (as long as there is an assignment) Physicians,

More information

PROFESSIONAL STAFF BY-LAWS OF GRAND RIVER HOSPITAL CORPORATION KITCHENER, ONTARIO TABLE OF CONTENTS

PROFESSIONAL STAFF BY-LAWS OF GRAND RIVER HOSPITAL CORPORATION KITCHENER, ONTARIO TABLE OF CONTENTS PROFESSIONAL STAFF BY-LAWS OF GRAND RIVER HOSPITAL CORPORATION KITCHENER, ONTARIO TABLE OF CONTENTS ARTICLE I APPLICATION...3 ARTICLE II - DEFINITIONS...3 ARTICLE III PURPOSE...4 ARTICLE IV PURPOSE OF

More information

Your People, Protected. Sports group Personal Accident Claim Form

Your People, Protected. Sports group Personal Accident Claim Form Your People, Protected Sports group Personal Accident Claim Form Sports group Personal Accident/Claim Form 2 Claim Form Dear Member, IMPORTANT INFORMATION, relevant to YOUR Claim, is contained on this

More information

EMR Outcomes Self-Assessment Contents

EMR Outcomes Self-Assessment Contents Contents Introduction... How does it work?... Select Purpose... Patient Care Processes... Registration and Attachment... Scheduler... Referral/Consult... 4 Assessment and Treatment... 5 Assessment-Ordering

More information

Only checking accounts can be used for Bill Payment purposes.

Only checking accounts can be used for Bill Payment purposes. INTERNET BILL PAYMENT SERVICE AGREEMENT The Internet Bill Payment service allows you to pay your bills electronically through a personal computer, rather than manually writing and mailing checks. You can

More information

EVEREST INSURANCE COMPANY OF CANADA ACCIDENT CLAIM FORM INSTRUCTIONS

EVEREST INSURANCE COMPANY OF CANADA ACCIDENT CLAIM FORM INSTRUCTIONS ACCIDENT CLAIM FORM INSTRUCTIONS Everest Insurance Company of Canada must receive your completed claim forms within thirty (30) days of the accident occurring. Complete the attached Sport Accident Claims

More information

9180 Katy Fwy Houston, TX 77055 713-984-1400 aokmedicalcenter.com

9180 Katy Fwy Houston, TX 77055 713-984-1400 aokmedicalcenter.com Effective Date: September 23, 2013 THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. If you have

More information

Health Claims for Auto Insurance July 2012 Guideline. July 2012. Superintendent s Guideline No. 02/12

Health Claims for Auto Insurance July 2012 Guideline. July 2012. Superintendent s Guideline No. 02/12 Financial Services Commission of Ontario Commission des services financiers de l Ontario Health Claims for Auto Insurance July 2012 Guideline July 2012 Superintendent s Guideline No. 02/12 Health Claims

More information

Public Employees Benefits Agency. Public Employees Disability Income Plan

Public Employees Benefits Agency. Public Employees Disability Income Plan Public Employees Benefits Agency Public Employees Disability Income Plan Table of Contents INTRODUCTION...4 Overview Administration Employee Booklet ELIGIBILITY...5 Employer Responsibility Enrolment BENEFITS...7

More information

Module 1: Claims Processing

Module 1: Claims Processing Module 1: 1.1 System 1.2 Interpreting Remittance Statements 1.1 System Teleplan Medical claims are submitted for payment electronically through the Medical Services Plan (MSP) Teleplan system. Introduction

More information

02 LC 28 0671-ECS (SCS) The Senate Insurance and Labor Committee offered the following substitute to SB 476: A BILL TO BE ENTITLED AN ACT

02 LC 28 0671-ECS (SCS) The Senate Insurance and Labor Committee offered the following substitute to SB 476: A BILL TO BE ENTITLED AN ACT The Senate Insurance and Labor Committee offered the following substitute to SB : A BILL TO BE ENTITLED AN ACT To provide a short title; to amend Title of the Official Code of Georgia Annotated, relating

More information

New Brunswick EMR Program. Functionality Workbook

New Brunswick EMR Program. Functionality Workbook New Brunswick EMR Program Functionality Workbook Standard EMR Functionality The following is an abbreviated list of features offered by Velante within the New Brunswick EMR Program. Data Management Highlights

More information

COLLEGE OF DENTAL TECHNICIANS OF BRITISH COLUMBIA

COLLEGE OF DENTAL TECHNICIANS OF BRITISH COLUMBIA COLLEGE OF DENTAL TECHNICIANS OF BRITISH COLUMBIA GENERAL INFORMATION REGARDING REGISTRATION AS A DENTAL TECHNICIAN AND REQUIRED LICENSURE EXAMINATIONS June 2014 Subject to revision [The College of Dental

More information

Health Insurance for International Visiting Scholars & Faculty

Health Insurance for International Visiting Scholars & Faculty Health Insurance for International Visiting Scholars & Faculty Health Insurance is required while you are working/researching at Stony Brook University. United States Federal Law requires you have adequate

More information

4.4 Attendance Management Policy

4.4 Attendance Management Policy Policy Statement The is committed to providing excellence in service to the general public. It is important for all employees of the Government of Nova Scotia to work as a team in the attainment of this

More information

Fair Registration Practices Report

Fair Registration Practices Report Fair Registration Practices Report Nurses (2013) The answers that you submitted to OFC can be seen below. This Fair Registration Practices Report was produced as required by: the Fair Access to Regulated

More information

ADMINISTRATION GUIDE. Answers to questions such as:

ADMINISTRATION GUIDE. Answers to questions such as: ADMINISTRATION GUIDE Answers to questions such as:»» How do I add or remove an employee from our plan?»» How soon do I let Group Insurance Solutions know about changes to salary or hours worked?»» What's

More information

APPENDIX 1: Frequently Asked Questions

APPENDIX 1: Frequently Asked Questions APPENDIX 1: Frequently Asked Questions Practice Name Q: What is the HIPAA Privacy Rule? A: The HIPAA Privacy Rule controls the use and disclosure of what is known as Protected Health Information (PHI).

More information

! Claims and Billing Guidelines

! Claims and Billing Guidelines ! Claims and Billing Guidelines Electronic Claims Clearinghouses and Vendors 16.1 Electronic Billing 16.2 Institutional Claims and Billing Guidelines 16.3 Professional Claims and Billing Guidelines 16.4

More information

Extended Health Care Dental Care Life Insurance Disability Insurance. Benefits Information for Executives

Extended Health Care Dental Care Life Insurance Disability Insurance. Benefits Information for Executives Extended Health Care Dental Care Life Insurance Disability Insurance Benefits Information for Executives SICKKIDS BENEFITS PLAN This brochure provides a brief description of the benefits plan offered by

More information

INDUSTRIAL CARPENTERS BENEFIT PLAN 160 4400 Dominion Street Burnaby BC V5G 4G3 Telephone 604-299-7482 Toll free 1-800-663-1356 Fax 604-299-8136

INDUSTRIAL CARPENTERS BENEFIT PLAN 160 4400 Dominion Street Burnaby BC V5G 4G3 Telephone 604-299-7482 Toll free 1-800-663-1356 Fax 604-299-8136 INDUSTRIAL CARPENTERS BENEFIT PLAN 160 4400 Dominion Street Burnaby BC V5G 4G3 Telephone 604-299-7482 Toll free 1-800-663-1356 Fax 604-299-8136 TABLE OF CONTENTS General Information 1 How to Qualify &

More information

OPIP Frequently Asked Questions

OPIP Frequently Asked Questions Eligibility: 1 Who is eligible to apply for OPIP? You are eligible to apply if you are a physician (excluding a resident) who: resides in Canada; is registered with the College of Physician and Surgeons

More information

Frequently Asked Questions

Frequently Asked Questions What you need to know when registering a business name. Do I have to register my business name? Should I register a business name or should I incorporate? How do I register my business name in Manitoba?

More information

Should any additional information be required, please do not hesitate to contact the Plan Administrator:

Should any additional information be required, please do not hesitate to contact the Plan Administrator: Group Health Insurance Plan for members - ENROLMENT PACKAGE 2015 We are pleased to enclose details of the coverage available under the plan sponsored by the Ordre des CPA and are confi dent that one of

More information