Effective June 2023, the Insurance Corporation of British Columbia (ICBC) implemented a new rule in which all invoices must be submitted with a new treatment plan.
In this blog, we’ll walk you through the basics of billing for ICBC, including what services are covered, how to bill for them, and some tips for making the process as smooth as possible.
What is ICBC?
ICBC provides coverage for medical services related to motor vehicle accidents. This coverage is available to anyone who is injured in a motor vehicle accident in British Columbia, regardless of who is at fault for the accident.
Some of the medical services ICBC covers include:
- Doctor visits
- Diagnostic imaging (such as X-rays and CT scans)
- Physiotherapy
- Massage therapy
- Chiropractic care
- Psychology and counselling services
- Occupational therapy
- Speech therapy
ICBC Claims Process
An ICBC injury claim includes several steps. Here is what the process looks like:
- Motor vehicle accident occurs.
- Injured person books an appointment with a physician.
- Physician conducts an assessment and completes the appropriate ICBC medical report.
- Physician creates a treatment plan and directs them to appropriate preapproved treatments (e.g., physiotherapy, occupation therapy, etc.).
- Physician provides standard follow-up visits as appropriate.
- Physician may refer to a Registered Care Advisor (RCA) where appropriate or necessary.
- Physician completes Reassessment Report as necessary.
- Physician provides ongoing management in line with overall care plan.
Medical Reports
A Standard or Extended report must be submitted for every individual that has been injured in a motor vehicle accident. Depending on the most responsible physician’s (MRP) discretion or at the request of the ICBC, you may also require a Reassessment report for an extended recovery case. The reports serve as both your medical record documentation and the invoice to ICBC.
Here is a chart highlighting the three ICBC report options and when they should be completed:
| Standard Report | Extended Report | Reassessment Report |
– Your patient’s injuries do not result in missed work or significantly affect their usual activities.
|
– Your patient’s injuries result in missed work or significant impairment of their ability to participate in usual activities. | – You would like to refer to an RCA. – Your patient’s injuries require a modified treatment plan. – A reassessment is requested by ICBC. |
Note: Reports and relevant invoices must be sent to ICBC through one of the following methods:
Fax:
1-877-686-4222
Mail:
ICBC
PO Box 2121 Stn Terminal
Vancouver BC V6B 0L6
Treatment Plan
By June 2023, physicians will be required to submit a treatment plan along with their invoice. Treatment plans are a means of documenting a patient’s progress to date and the functional outcomes they will achieve with further treatment. This information enables ICBC claims representatives to make fair, consistent, and evidence-informed benefit decisions and enables treatment continuity and access.
Treatment Plan Requirements
Here are the requirements for completing a treatment plan:
- The functional progress made to date and the functional or return-to-work goals that will be achieved through additional treatments.
- The active interventions that are planned to achieve the listed recovery goals.
- Other factors that may be contributing to our customers’ recovery.
ICBC claims representatives may contact health care providers when further information about the treatment recommendations and function-based outcomes outlined in a treatment plan is required.
Billing for ICBC Services
Physicians can submit their ICBC claims through the MSP billing system. To bill for ICBC services, you will need to use the following set of codes.
| Item | Billing Code | Amount |
| Standard Report (CL489) | A94564 | $120 |
| Extended Report (CL489A) | A94565 | $325 |
| Reassessment Report (CL489B) |
A94566 |
$210 |
| Regular follow-up appointment (i.e., without Reassessment Report) | Usual MSP code and EMR designation to indicate crash | Various |
| If consent not given, initial appointment charged as regular appointment | Usual MSP code and EMR designation to indicate crash | Various |
| If consent not given, extra time to complete and send report after ICBC request for report | Standard or Extended Report as needed |
Various
|
| If Standard Report sent but Extended Report needed, time for conversation with ICBC to obtain extra details | A94569 for physician conference fee | $60 |
| If walk-in clinic, initial appointment for care given after crash, but no report filled out | Usual MSP code and EMR designation to indicate crash | Various
|
| If walk-in clinic needs second appointment to complete initial report if no family physician | Standard or Extended Report as needed | Various
|
Physician conference fee (For calls between MRP, RCA, ICBC and others on care team – per 15 minutes up to a maximum of 45 minutes per day) |
A94569 | $60 |
Physician telephone management fee (For calls between physician and patient) |
A94571
|
$25 |
When submitting a claim for ICBC services, you will need to include additional information, such as the patient’s claim number and the date of the accident. You will also need to indicate that the services were provided as a result of a motor vehicle accident.
Patient Consent
As of April 2019, physicians are required to obtain explicit consent for disclosure of personal health information to a third party. Consent can be given verbally or in writing. If you would like to obtain written consent from your patients, you can use this form created by Doctors of BC.
If you do not receive consent.
Please invoice for a standard visit following normal visits. It is recommended that you use the report as the visit template so that it can be readily provided upon later request.
When consent is provided later.
When a request letter obligates the physician to provide the report, an assessment visit and report fee will be paid upon receipt of the report and compensates for the additional administrative work of providing the report.
In conclusion, billing for ICBC services can be a complex process, but with the right information and approach, it can be done efficiently and effectively. By understanding what services are covered, using the correct billing codes, and keeping good records, you can ensure that you’re billing for ICBC services in the most effective way possible.
Need Assistance? We Can Help!
DoctorCare helps doctors sort through confusing billing rules, automate billing submissions, ensure errors are fixed, and optimize billings to maximize revenue. If you are interested in learning more about how we can help, contact us to set up a free consultation.
