Strategies to Optimize Your Medical Billings Revenue During COVID-19

While the country continues to be challenged by the COVID-19 pandemic we are focusing on the variety of financial supports that can help doctors make up for lost medical billings revenue due to COVID-19.

MOH Funding Increases & Retroactive Payment Adjustments During COVID-19

The MOH has confirmed that its systems have been updated to process the increases in payment allocated to primary care physicians effective April 1, 2020. FHO physicians will see a base rate capitation (salary) increase of 1.71% and all GPs will see a fee hike to many everyday billing codes (refer to the latest Schedule of Benefits). Your first payment increase will be reflected in your May 2020 deposit.

In addition, physicians will automatically receive their 2018-2019 retroactive adjustments in their April 2020 deposit. DoctorCare will once again support our FHO groups with calculating each member’s allocated share from the reconciled group funds deposited into the FHO account.

Preventive Care Bonuses

Your Preventive Care bonuses of up to $12,800 are eligible to be billed starting April 1, 2020. Please remember to backdate your bonus submissions to March 31, 2020. If you require support with your calculations or billing, we can help.

Roster Reconciliations to Increase Salaried Payments

There are tangible benefits to capitated funding models (such as FHO/FHG) where up to 75% of your income is guaranteed. Ensuring that your roster has been reconciled is a great step in capturing any missed medical billings revenue opportunity. The DoctorCare team can help you identify the patients that you are actively seeing, think are enrolled, and yet are not receiving capitation payments from the MOH. These patients can be re-enrolled to your practice to increase your monthly salaried payment.

Timely Distribution of Access Bonus Payments during COVID-19

For FHO physicians, March 30th marks the end of the most recent Access Bonus period. This means that groups with a positive Access Bonus have funds to distribute to members (according to your FHO group governance). DoctorCare managed FHOs that have elected to receive direct deposits will receive their Access Bonus payments before the end of the month. We can help your group with your calculations and timely distribution of funds during COVID-19.

OTN Billings and Documentation of Virtual Visits During COVID-19

If you are registered for OTN, there are financial benefits to doing your consults by video for rostered patients during COVID-19. As long as you meet requirements, these visits can be billed (and are paid) at the same amount as an in-person visit. Remember to track these visits with the new B203 add-on code ($0).

  • You can only bill OTN codes for rostered patients. Non-rostered patients must be billed using the new K-Codes (K080, K081, K082). We can guide you through the billing process for OTN.
  • If you are not registered for OTN, you can bill the K-Codes (K080, K081, K082) where appropriate.
  • These visits must be documented properly.  We suggest you use a slightly modified SOAP note for these visits that include documentation of patient consent and start/stop times. We can guide you in setting this up in your EMR and we can remotely add stamps/templates for your use.

Are you interested in setting up Virtual Care?

There are no restrictions on the platform you can use. However, if your technology of choice has not passed PHIPA rules (where consent is received upon sign up e.g. with OTN invite), then you must obtain consent from the patient and ensure it is documented in their chart. The OMA has put together legal verbiage and patient-centred messaging that physicians can use here.

We continue to monitor changes and guidance from federal, provincial, and municipal public health authorities to ensure we have the most current information and remain committed to providing support to our doctors in any way we can.

To learn more about virtual care billing in Ontario, read our blog on A Comprehensive Guide to OHIP Billing Codes for Virtual Care and COVID-19 here.

Subscribe to our Newsletter

Sign up for periodic emails on company news, blogs, events, product news, and marketing offers. We respect your inbox and you can unsubscribe at any time.