Opted In Practitioners

Opted In practitioners are bound by the MSP Fee Schedule. When treating an MSP eligible patient, Opted In practitioners must limit their fees to $23 per a visit and bill MSP and not the patients. An example of an Opted In practitioner would be a physiotherapist employed by a hospital.

Opted In and WorkSafeBC and ICBC Billing

In some cases MSP acts as a billing agent for WorkSafeBC and ICBC. Being Opted In to MSP has no impact on ICBC and WorkSafeBC billing. Fees are determined by ICBC or WorkSafeBC schedule for each profession. Payments are made in accordance with MSP Payment Schedule. Read “Bill ICBC and WorkSafeBC via Teleplan” to learn if MSP can be your ICBC or WorkSafeBC billing agent.

Payees of Insurance Benefits for Opt In Billing Option

Payees of MSP claims – Practitioners, $23;
Payees of ICBC claims – Practitioners, per ICBC Fee Schedule;
Payees of WorkSafeBC claims – Practitioners, per WorkSafeBC Fee Schedule.

Opted In and Direct Bank Deposit

Opted In practitioners are eligible for direct bank deposits from MSP for their MSP, ICBC and WorkSafeBC payments. Read more in section “Collecting MSP Payments”.

Opted In practitioners and Close Off Days

Opted In practitioners can submit claims every day, but they do not get processed until a scheduled close off day. There are two close off days in a month, which are set by MSP Payment Schedule. All claims successfully submitted before a close off are paid off about two weeks later, on a corresponding payment day.  Claims submitted after a close off will not be processed until the next close off. A payment report (aka remittance report) usually arrives two days before a payment day.

Opted In and Frequency of Payments

Opted In practitioners get MSP payments twice a month in accordance with an annual MSP payment schedule. This frequency of payments applies to all MSP, ICBC or WorkSafeBC claims. Each payment day corresponds to a preceding close off day.

Opted In and Assignment of Payments

Opted In practitioners working for a clinic, hospital or another practitioner can make them the payees of their MSP, WorkSafeBC and ICBC payments as long as they have the same billing option (which is Opted In). Read section “Working for a Clinic: Assigning MSP payments to a clinic” to learn more.

Opted In and Patients’ files

No additional forms are required to be signed and kept in patients’ file for Opted In practitioners.

Pros and Cons of being an Opted In Practitioner

Pros

• Suitable for work in hospitals or other opted in organizations
• Affordable for low-income patients
• Less paperwork in patients’ files
• Eligible for semimonthly bank deposits

Cons

• Low or negative profit margin for self-employed practitioners
• Need to track accounts receivable; if claims are declined, the fee must be collected from a patient

Summary

Opted In status is most suitable for practitioners working for organizations that are bound by MSP fee schedule and do not routinely charge their patients, such as hospitals. Opted In practitioners assign their payments to a hospital and receive wages with no overhead cost of running their own practice. Self-employed practitioners are better suited for Opted Out status because their charge to MSP Premium Assistance patients is not limited to $23.

How to become Opted In

To register with MSP as an Opted In practitioner, obtain an Opted In MSP practitioner number:

1. Complete Practitioner registration form (HLTH 2848)
2. Fax this form to the number indicated on its bottom
3. Call Teleplan support in three business days to follow up.

Notes:

1. Check off the box “Opt In (Bill the Medical Service Plan)” in the middle section “Billing Option: Important”.

After your form is processed you will receive an Opted In MSP practitioner number, also called MSP payment number or MSP billing number. MSP practitioner number has five digits and looks like 12345. Do not confuse it with your college number.

Why do you need MSP practitioner number

MSP practitioner number is the result of your registration with MSP. It shows that Medical Services Plan recognizes you as an authorized treating practitioner and a payee of MSP benefits. Each practitioner who plans to treat MSP eligible patients needs to obtain an MSP practitioner number. It will be indicated in all your MSP claims and used to enroll you in MSP Teleplan. Your MSP payment number always bears a billing option, either Opted In or Opted Out.

Opted Out Practitioners

Unlike physicians, most practitioners can opt out of MSP fee schedule and charge their patients over the limit of $23. MSP will still cover $23 per a visit for a combined limit of ten visits per a year for eligible patients, but patients are responsible for the remainder of the fees. An example of an Opted Out practitioner would be a self-employed acupuncturist.

Limiting fees

Opted Out practitioners are not prohibited from limiting their fees to $23. They can create different payment schedules for different groups of patients, offering low-fee service to patients in financial need.

Pros and Cons of being Opted Out

Pros

• Equal profit margins for MSP Premium Assistance and private patients
• Annual MSP benefits of $230 makes services more affordable for low income patients

Cons

• Not all MSP eligible patients can afford to pay over $23 per a visit

How to become Opted Out

To register with MSP as an Opted Out practitioner, obtain an Opted Out MSP practitioner number

1. Complete Practitioner registration form (HLTH 2848)
2. Fax this form to the number on its bottom
3. Call Teleplan support in three business days to follow up.

Notes:

1. Check off the box “Opt Out (Bill the Patient)” in the section “Billing Option: Important” in form HLTH 2848.

After your form is processed you will receive an Opted In MSP practitioner number, also called MSP payment number or MSP billing number. MSP practitioner number has five digits and looks like 12345. Do not confuse it with your college number.

Why do you need MSP practitioner number

MSP practitioner number is the result of your registration with MSP. It shows that Medical Services Plan recognizes you as an authorized treating practitioner and a payee of MSP benefits. Each practitioner who plans to treat MSP eligible patients needs to obtain an MSP practitioner number. It will be indicated in all your MSP claims and used to enroll you in MSP Teleplan. Your MSP payment number always bears a billing option, either Opted In or Opted Out.

Hard Opt Out and Soft Opt Out

After you opt out, you need to decide who will collect the MSP portion of your fees, you or your patients. If money is sent to you, you are called Soft Opt Out. If money is sent to your patients, you are Hard Opt Out. This choice is important for many reasons as both options bear their cons and pros. Read “Whom to Bill: a Patient or MSP” to make the right choice.

Soft Opt Out Practitioners

If you choose to bill $23.00 to MSP and the remainder of your fee to a patient, you become Soft Opt Out. Soft Opt Out is the most popular billing option for healthcare practitioners.

Soft Opt Out and WorkSafeBC and ICBC Billing

In some cases MSP acts as a billing agent for WorkSafeBC and ICBC. Being Soft Opted Out to MSP has no impact on ICBC and WorkSafeBC billing. Fees are determined by ICBC or WorkSafeBC schedule for each profession. Payments are made in accordance with MSP Payment Schedule. Read “Bill ICBC and WorkSafeBC via Teleplan” to learn if MSP can be your ICBC or WorkSafeBC billing agent.

Payees of Insurance Benefits for Soft Opt Out Billing Option

Payees of MSP claims – Practitioners, $23;
Payees of ICBC claims – Practitioners, per ICBC Fee Schedule;
Payees of WorkSafeBC claims – Practitioners, per WorkSafeBC Fee Schedule.

Soft Opt Out and Close Off Days

Soft Opt Out practitioners can submit claims every day, but they do not get processed until a scheduled close off day. There are two close off days in a month, which are set by MSP Payment Schedule. All claims successfully submitted before a close off are paid off about two weeks later, on a scheduled payment day. Claims submitted after a close off will not be processed until the next close off. A payment report (aka remittance report) usually arrives two days before a payment day.

Soft Opt Out and Frequency of Payments

Soft Opt practitioners get MSP payments twice a month in accordance with an annual MSP Payment Schedule. This frequency of payments applies to all MSP, ICBC and WorkSafeBC payments. Each payment day corresponds to a preceding close off day.

Soft Opt Out and Direct Bank Deposit

Soft Opt Out practitioners are eligible for direct bank payments from MSP. Read more in section “Collecting MSP Payments.”

Soft Opt Out and Patients’ Files

Every MSP Premium Assistance patient needs to sign an Assignment of MSP Benefit to Opted Out Practitioner. This form has to be kept in a patient’s file.

Soft Opted Out and Online Forms

Soft Opted Out practitioners are not permitted to use Online Forms to submit their claims.

Soft Opt Out and Assignment of Payments

Soft Opt Out practitioners are allowed to assign their payments to a clinic or another practitioner if they work for one.

Pros and Cons of Soft Opt Out

Pros

• Patients are attracted by an instant discount of $23.00
• Eligible for semimonthly bank deposits for all MSP, WorkSafeBC and ICBC payments
• Eligible for assignment of payments

Cons

• Extra paperwork in patients’ files
• Need to track accounts receivable; If claims are declined, the fee must be collected from a patient

Summary

Choose Soft Opt Out status if you want to indulge your MSP Premium Assistance patients with an immediate discount of $23 even if it involves an occasional work of collecting declined MSP payments from them. You will also get a bonus of direct bank payments and an option to assign your payments to a clinic if you work for one. If you have neither time nor resources to track down your patients for declined MSP payments, choose Hard Opt Out.

HOW TO BECOME SOFT OPT OUT

To become Soft Opt Out, declare yourself a payee of MSP benefits

1. Complete an Agreement between MSP and opt out practitioner
2. Fax it to the number on its bottom
3. Follow up in three business days

Notes:

1. The signing date on your Agreement matters. Read “Working Solo” section to learn why.

Hard Opt Out Practitioners

Hard Opt Out practitioners bill their MSP Premium Assistance patients full amount; their patients collect their MSP benefits themselves. Billing MSP on patients’ behalf is still responsibility of the practitioners. Hard Opt Out billing option requires least administrative work and has highest collection rate of MSP payments. Nevertheless, Hard Opt Out billing option is far less popular than Soft Opt Out. Keep reading to find out why.

Hard Opt Out and Close Off

MSP accepts claims every day but does not process them until a close off day. A close off day for Hard Opted Out practitioners happens only once a month. It is the last scheduled close off of a month on MSP Payment Schedule.

Hard Opt Out and Frequency of MSP Payments

Hard Opt Out practitioners never receive MSP payments but they receive payment reports regarding their patients’ claims. The remittance reports come once a month, about two weeks after a corresponding close off on the MSP Payment Schedule. If claims are rejected due to an error, practitioners are supposed to correct and resubmit the claims.

 HARD OPT OUT AND WORKSAFEBC AND ICBC BILLING

In some cases MSP acts as a billing agent for WorkSafeBC and ICBC. Fees are determined by ICBC or WorkSafeBC schedule for each profession. Payments are made in accordance with MSP Payment Schedule. MSP Teleplan processes ICBC and WorkSafeBC claims twice a month on each close off day of MSP Payment Schedule. Payments are also made twice a month. A payment report (aka remittance report) usually arrives two days before a payment day. Declined ICBC and WorkSafeBC claims must be collected from patients. Read “Bill ICBC and WorkSafeBC via Teleplan” to learn if MSP can be your ICBC or WorkSafeBC billing agent.

Payees of Insurance Benefits for Hard Opt Out Billing Option

Payee of MSP claims – Patients, $23;
Payee of ICBC claims – Practitioners, per ICBC Fee Schedule;
Payee of WorkSafeBC claims – Practitioners, per WorkSafeBC Fee Schedule.

Hard OPT OUT AND DIRECT BANK DEPOSIT

Hard Opt Out practitioners are NOT eligible for direct bank payments from MSP because they are not MSP payees. MSP reimburses patients directly, sending cheques to patients’ homes.

Hard Opt Out practitioners are payees of ICBC and WorkSafeBC payments, but they are still not eligible for direct bank payments. They receive their payments by cheques, issued in their names. Read more on the subject in section “Collecting MSP payments.”

HARD OPT OUT AND PATIENTS’ FILES

Hard Opt Out practitioners must include patients’ address in each MSP claim, but if MSP has a different address on a patient’s file the cheques might be mailed to it. To shift responsibility for lost payments, it is recommended that Hard Opt Out practitioners include a free-form signed form in each MSP payee’s file that states that patients understand that MSP might mail their MSP benefits to their address on MSP file. It is patients’ responsibility to ensure that MSP has their current mailing address.

Pros and Cons of Being Hard Opt Out

Pros

• No need to handle accounts receivable for MSP claims, but not for ICBC and WorkSafeBC

Cons

• Still have to bill  and re-bill MSP on behalf of the patients
• Have to collect declined ICBC and WorkSafeBC payments from patients
• Might alienate patients seeking instant MSP benefits

Summary

Choose Hard Opt Out if you are a self-employed practitioner who cannot stand to deal with occasionally declined MSP claims. Remember, that you will still be collecting declined ICBC and WorkSafeBC claims and handling their cheques, if any. In addition, you will not be able to assign your payments to a clinic or another practitioner if you work for one.

HOW TO BECOME HARD OPT OUT

To become HARD Opt Out, do not declare yourself a payee of MSP benefits

1. Do not submit Agreement with MSP
2. If you have submitted it before, fax Teleplan a free-form letter asking to recant it.

Notes:

1. The signing date on your recanting letter matters. Read “Working Solo” section to learn why.

MSP Teleplan registration for Opted In practitioners

To obtain your MSP Teleplan Data Centre

1. Complete Application for Teleplan Service (HLTH 2820)
2. Fax it to the number on its bottom and to us
3. Follow up in three business days

To request direct bank payment from MSP (optional)

1. Add  Application for direct bank payment from MSP (HLTH 2832)
2. Fax it to the number on its bottom along with your HLTH 2820

Notes:

1. You have to have an MSP practitioner number to apply for Teleplan. Read “Become Opted In” section to learn more about getting MSP number.
2. Predate Application for Teleplan Service (HLTH 2820) to match the first date of service that you need to bill for.
3. You can submit claims for services performed at different locations via the same Data Centre. Use Claim Manager to submit all your claims with one account.

MSP Teleplan registration for Soft Opt Out practitioners

To obtain your MSP Teleplan Data Centre

1. Complete an Application for Teleplan Service (HLTH 2771)
2. Fax it to the number on its bottom and to us
3. Follow up in three business days

To ensure that you are Soft Opt Out

1. Add an Agreement with MSP if you haven’t done it before
2. Fax it to the number on its bottom

Read “Become Soft Opt Out” section for more information about this billing option.

To request direct bank payment

1. Add Application for direct bank payment from MSP (HLTH 2832)
2. Fax it to the number on its bottom

Notes:

1. You have to have an MSP Practitioner number to apply for Teleplan. Read “Become Opted Out” section to learn more about getting MSP number.
2. Predate Application for Teleplan Service (HLTH 2771) and Agreement with MSP to match the first date of service that you need to bill for.
3. You can submit claims for services performed at different locations via the same  MSP Teleplan Data Centre. Use Claim Manager to submit all your claims with one account.

MSP Teleplan registration for Hard Opt Out practitioners

To obtain your MSP Teleplan Data Centre

1. Complete an Application for Teleplan Service (HLTH 2771)
2. Fax it to the number on its bottom and to us
3. Follow up in three business days

To ensure that you are Hard Opt Out

1. Do NOT sign an Agreement with MSP

If you have signed your Agreement before, recant it. Read “Become Hard Opt Out” section for more information about this billing option.

Notes:

1. You have to have an MSP Practitioner number before you apply for Teleplan. Read “Become Opted Out” section to learn more about getting MSP number.
2. Predate Application for Teleplan Service (HLTH 2771) to match the first date of service that you need to bill for.
3. Put a note anywhere on your HLTH 2771 form or in a cover letter: “Agreement is not needed. Patients get the money.”
4. You can submit claims for services performed at different locations via the same Data Centre. Use Claim Manager to submit all your claims with one account.

Hard Opt Out: from the MSP Online Form to MSP Teleplan

To obtain an MSP Teleplan Data Centre Number

1. Complete an MSP Application for Teleplan Service Opted Out Practitioners (HLTH 2771)
2. Fax it to the number on its bottom and to us
3. Follow up in three business days

To ensure that you are Hard Opt Out

1. Do NOT sign an Agreement with MSP

If you have signed your Agreement before, recant it. Read “Become Hard Opt Out” section for more information about this billing option.

Notes:

1. Put a note anywhere on your HLTH 2771 form or in a cover letter: “Agreement is not needed. Patients get the money.”
2. Predate Application for Teleplan Service (HLTH 2771) to match the first date of service that you need to bill for with Teleplan.
3. You can submit claims for services performed at different locations via the same Data Centre. Use Claim Manager to submit all your claims with one account.

Changes:

1. You will see no changes in a form or frequency of MSP, ICBC or WorkSafeBC payments;
2. You will start receiving your remittance (payment) reports electronically same day as they are released;
3. You will be able to prepare all kinds of income reports for flexible time periods;
4. You will be notified about any errors in your claims within 24 hours;
5. Your will be able to check MSP eligibility of your patients in real time while creating a claim;
6. Your billing will be integrated into your patients’ management system.

Hard Opt Out: from the MSP Form to Teleplan and Soft Opt Out

To obtain an MSP Teleplan Data Centre Number

1. Complete MSP Application for Teleplan Service Opted Out Practitioners (HLTH 2771).
2. Fax it to the number on its bottom and to us
3. Follow up in three business days; we will establish your MSP Teleplan connection on a day when you get your MSP Teleplan DCN.

To become Soft Opt Out

1.  Add an Agreement between Medical Services Plan, Ministry of Health and Practitioner
2. Fax it to the number on its bottom

Read “Become Soft Opt Out” section for more information about this billing option.

To request direct bank payments from MSP (optional)

1. Add Application for Direct Bank Payment from Medical Service Plan (MSP) HLTH 2832
2. Fax it to the number on its bottom

Important:

1. Date Application for Teleplan Service (HLTH 2771) and Agreement with MSP to match match the first date of service that you need to bill for as Soft Opt Out.
2. Claims with dates of services that precede the signing date of the Agreement will be paid in cheques issued to patients’ names. Make sure to charge your patients full amounts for those dates.
3. Stop billing your MSP patients for a full amount on the date of change as you will be billing $23 to MSP from that day onward.

Changes:

1. You will become a payee of MSP claims only on the signing date of the Agreement. Services performed before that date will be paid to your patients.
2. Your MSP payments for services as Soft Opt Out will come as direct bank payments if you requested that or as cheques issued in your name. They will be made twice a month in accordance with MSP Payment schedule.
3. MSP payments for services performed as Hard Opt Out will come as cheques issued in patients’ names.
4. You will start receiving your remittance (payment) reports electronically same day as they are released;
5. You will be able to prepare all kinds of income reports for flexible time periods;
6. You will be notified about any errors in your claims within 24 hours;
7. Your will be able to check MSP eligibility of your patients in real time while creating a claim;
8. Your billing will be integrated into your patients’ management system.

Opted In: From the MSP Online Form to MSP Teleplan

To obtain an MSP Teleplan Data Centre Number

1. Complete an Application for Teleplan Service (HLTH 2820)
2. Fax it to the number on its bottom and to us
3. Follow up in three business days; we will establish your MSP Teleplan connection on a day when you get your MSP Teleplan DCN.

To request direct bank payments (optional)

1. Add Application for Direct Bank Payment from Medical Services Plan (MSP) if you haven’t done it before
2. Fax it the number on its bottom.

Notes:

1. Predate Application for Teleplan Service (HLTH 2820) to match the first date of service that you need to bill for with Teleplan.
2. You can submit claims for services performed at different locations via the same Data Centre. Use Claim Manager to submit all your claims with one account.

Changes:

1. You will see no changes in a form or frequency of MSP, ICBC or WorkSafeBC payments unless you haven’t had a direct bank payment request before;
2. You will start receiving your remittance (payment) reports electronically same day as they are released;
3. You will be able to prepare all kinds of income reports for flexible time periods;
4. You will be notified about any errors in your claims within 24 hours;
5. Your will be able to check MSP eligibility of your patients in real time while creating a claim;
6. Your billing will be integrated into your patients’ management system.

From Opt In to Soft Opt Out and Teleplan

To become Opted Out

1. Fax a free-form letter to MSP Teleplan support requesting to change your billing option from Opted In to Opted Out.

To become Soft Opt Out

1. Add an Agreement between Medical Services Plan, Ministry of Health and Practitioner

Read “Become Soft Opt Out” section for more information about this billing option.

To obtain an MSP Teleplan Data Centre Number

1. Complete an Application for Teleplan Service (HLTH 2771)
2. Fax it to the number on its bottom and to us
3. Follow up in three business days; we will establish your MSP Teleplan connection on a day when you get your MSP Teleplan DCN.

To request direct bank payments (optional)

1. Add an Application for Direct Bank Payment from Medical Service Plan (MSP) HLTH 2832 if you haven’t done it before.

Fax the signed forms to the numbers on their bottoms. Receiving a Teleplan Data Centre takes a couple of business days. You can wait for a letter or you can call Teleplan support to obtain it sooner.

Notes:

1. Put same dates on your Agreement with Teleplan and letter to change your billing option. You may want to match it to a day after a close off day.
2. You may want to put same date on your HLTH 2771.
3. You shall not bill your MSP Premium Assistance Patients over $23 until your Opted In status is changed to Opted Out.
4. You can submit claims for services performed at different locations via the same Data Centre. Use Claim Manager to submit all your claims with one account.
5. Consult with Teleplan support before submitting your forms as this is a tricky transition.

Changes:

1. You will be able to charge MSP eligible patients over $23 on the date when you become Opted Out.
2. You will remain a payee of MSP benefits because you change to Soft Opt Out.
3. You will not see a change in a form or frequency of payments from MSP because you remain a payee of MSP benefits under both Opt In and Soft Opt Out options.
4. You will start receiving your remittance (payment) reports electronically same day as they are released;
5. You will be able to prepare all kinds of income reports for flexible time periods;
6. You will be notified about any errors in your claims within 24 hours;
7. Your will be able to check MSP eligibility of your patients in real time while creating a claim;
8. Your billing will be integrated into your patients’ management system.

From Opt In to Hard Opt Out and MSP Teleplan

To become Opted Out

1. Fax a free-form letter to MSP Teleplan support requesting to change your billing option from Opted In to Opted Out.

To become Hard Opt Out

1. Do NOT add an Agreement between Medical Services Plan, Ministry of Health and Practitioner

Read “Become Hard Opt Out” section for more information about this billing option.

To obtain an MSP Teleplan Data Centre Number

1. Complete an Application for Teleplan Service (HLTH 2771)
2. Fax it to the number on its bottom and to us
3. Follow up in three business days; we will establish your MSP Teleplan connection on a day when you get your MSP Teleplan DCN.

Important:

1. Put same dates on your Agreement with Teleplan and your HLTH 2771.
2. Put a note anywhere on your HLTH 2771 form or in a cover letter: “Agreement is not needed. Patients get the money.”
3. You shall not bill your MSP Premium Assistance Patients directly until your Opted In status is changed to Opted Out.
4. You shall not bill your MSP Premium Assistance Patients over $23 until your Opted In status is changed to Opted Out.
5. You will stop being a payee of MSP benefits on a day of transfer to Opted Out. Your patients will become MSP payees.
6. You will remain a payee of ICBC and WorkSafeBC benefits if any.
7. Your remittance reports will be coming only once a month now; only ICBC and WorkSafeBC reports will be coming twice a month.
8. You can submit claims for services performed at different locations via the same Data Centre. Use Claim Manager to submit all your claims with one account.

Soft Opt Out Leaving for Their Own Teleplan DCN

To obtain an MSP Teleplan Data Centre

1. Complete Application for Teleplan Service  (HLTH 2771)
2. Fax it to the number on its bottom
3. Follow up in three business days.

Important:

Change your Data Centers when MSP Teleplan has none of your claims in process. To make this happen

1. Stop submitting any claims with your old Data Centre after the next close off date,
2. Receive remittance for that close off  period in your old software
3. Start submitting your claims with your new software the day after the remittance

This planning will ensure that all remittances are received by the same software that submitted the claims, making your reporting easier. It will also ensure that you don’t miss a single payment during your transition.

Notes:

1. Put a note anywhere on form HLTH 2771 or in a cover letter: “Please transfer me on [the next day after your next remittance]”.

Changes:

1. Your claims will be stored in your own database from now on.
2. You will be in charge of your own billing.
3. You can add additional users to your Teleplan DCN and share a database of patients with them.
4. You can change from one billing software to another without abandoning your personal Teleplan Data Centre provided that software supports an independent Teleplan DCN.

HARD OPT OUT LEAVING FOR THEIR OWN TELEPLAN DCN

To obtain an MSP Teleplan Data Centre

1. Complete Application for Teleplan Service  (HLTH 2771)
2. Fax it to the number on its bottom
3. Follow up in three business days.

Important:

Change your Data Centers when MSP Teleplan has none of your claims in process. To make this happen

1. Stop submitting any claims with your old Data Centre after the next close off date (which is the second close off day on MSP Teleplan monthly payment schedule),
2. Receive remittance for that close off  period in your old software,
3. Start submitting your claims with your new software the day after the remittance.

This planning will ensure that all remittances are received by the same software that submitted the claims, making your reporting easier. It will also ensure that you don’t miss a single payment during your transition.

Notes:

1. Put a note anywhere on form HLTH 2771 or in a cover letter: “Please transfer me on [the next day after your next remittance]”.

Changes:

1. Your claims will be stored in your own database from now on.
2. You will be in charge of your own billing.
3. You can add additional users to your Teleplan DCN and share a database of patients with them.
4. You can change from one billing software to another without abandoning your personal Teleplan Data Centre provided that software supports an independent Teleplan DCN.

 

Opted In Leaving for Their Own MSP Teleplan DCN

To obtain an MSP Teleplan Data Centre

1. Complete Application for Teleplan Service (HLTH 2820)
2. Fax it to the number on its bottom and to us
3. Follow up in three business days

Important:

Change your Data Centers when MSP Teleplan has none of your claims in process. To make this happen

1. Stop submitting any claims with your old Data Centre after the next close off date,
2. Receive remittance for that close off  period in your old software,
3. Start submitting your claims with your new software the day after the remittance.

This planning will ensure that all remittances are received by the same software that submitted the claims, making your reporting easier. It will also ensure that you don’t miss a single payment during your transition.

Notes:

1. Put a note anywhere on form HLTH 2820 or in a cover letter: “Please transfer me on [the next day after your next remittance]”.

Changes:

1. Your claims will be stored in your own database from now on.
2. You will be in charge of your own billing.
3. You can add additional users to your Teleplan DCN and share a database of patients with them.
4. You can change from one billing software to another without abandoning your personal Teleplan Data Centre provided that software supports an independent Teleplan DCN.

If you want to remain an MSP payee while delegating your MSP billing to clinic’s staff, join the clinic’s MSP Teleplan Data Centre. If that is your first DCN, read “Remaining an MSP Payee in a full-time clinic”. If this is your second or greater DCN, keep reading.

How to Join Two or More Teleplan Data Centres

Joining an MSP Teleplan Data Centre requires a unique MSP billing number. If your MSP practitioner number is already attached to your own Teleplan DCN, you need to apply for an additional MSP number before you can join another Teleplan Data Centre.

MSP practitioner and payment numbers

Each practitioner can have multiple MSP numbers. First number issued by MSP is called MSP practitioner number. All consecutive numbers are called MSP payment numbers. You can have one MSP practitioner number and multiple MSP payment numbers. If you only have one MSP number, it is both your practitioner and your payment number of MSP.

Why do you need multiple MSP numbers

Multiple MSP payment numbers are required to join multiple Teleplan Data Centres. There are other reasons to apply for additional MSP payment numbers. For example, you can do it on behalf of a clinic to make your clinic an MSP payee.

Billing Options of MSP payment numbers

All MSP payment numbers will have same billing option as your MSP practitioner number: Opted Out or Opted In. A practitioner is not allowed to have numbers with the both billing options. Only Soft Opt Our and Hard Opt Out variations are allowed simultaneously.

How to use MSP practitioner number and MSP payment number in claims

Each MSP claim contains information about a practitioner who performed a treatment and a payee who receives the payment. If you bill via your own DCN, you will indicate your MSP practitioner number in both fields. If you joined a clinic’s DCN, you will use your additional MSP payment number to indicate a payee.

When to apply for MSP payment number

Apply for additional MSP payment number if

• your practitioner number is already attached to your own DCN
• you want another clinic to handle your MSP billing at that place
• you want to remain an MSP payee at the clinic.

Another reason to apply for an additional MSP payment number is when you want to obtain one for your clinic. Read more about it in section “Running a clinic: Making a clinic an MSP payee (Assignment of Payments)”.

Assignment of Payments versus Additional MSP Payment Number

If you want your part-time clinic to by a payee of your MSP funds, don’t obtain an additional MSP payment number and/or join the clinic’s Teleplan DCN. Apply for an Assignment of Payments instead. Assignment of payments allows a clinic to do MSP billing on your behalf and to collect your payments without joining you to its Teleplan Data Centre.

How to apply for MSP payment number

To apply for MSP payment number

1. Complete and submit Application for Additional Payment Number (HLTH 2976).
2. Fax it to the number on its bottom
3. Follow up in three business days.

Notes:

1. In Secion A, enter your MSP practitioner number, your full name and any MSP payment numbers that you currently have, along with your mailing address.
2. In Section B, check off item 5 “Other”. Enter: joining additional Teleplan Data Centre.
3. After your form is processed you will receive a five digit MSP payment number.

To make your new MSP payment number Soft Opt Out

1. Add an Agreement between Medical Services Plan, Ministry of Health and Practitioner

To request direct bank payment for your new MSP payment number

1. Add an Application for Direct Bank Payment from Medical Service Plan (MSP)

How to Join a Teleplan DCN: OPT OUT

To join an MSP Teleplan DCN

1. Complete an Application for Teleplan Service  (HLTH 2771)
2. Fax it to the number on its bottom
3. Follow up in three business days

How to Join an MSP Teleplan DCN: Opted In

To join a Teleplan Data Centre

1. Complete an Application for Teleplan Service (HLTH 2820).
2. Fax it to the number on its bottom
3. Follow up in three business days

Notes for Opted Out and Opted In:

1. Use your new MSP payment number in MSP payee or MSP payment number fields.
2. Fill in subsection “Joining Existing Data Centre” in “Data Centre Informaiton” section. Enter the Data Center Number that you want to join in “Data Centre Number” field. If you don’t know the name of the Data Centre, leave it empty.
3. Disregard subsections “New Data Centre” and “Re-activate Previous Data Centre”.
4. If you are joining a Teleplan DCN with your new MSP payment number, you can do it on any day in MSP billing cycle. Make sure to predate your HLTH 2771 and 2820 and Agreement with Teleplan with an earliest date of service that you want to bill for via your new DCN.

If you want to move to a clinic full-time, you need to leave your old Data Centre Number for a Data Center Number of the clinic. Since it is going to be your only Teleplan DCN, no additional MSP payment number is required. You can change your Teleplan Data Centers as often as you need.

MSP Opt Out Practitioners

To change your MSP Teleplan Data Centre

1. Complete an  Application for Teleplan Service  (HLTH 2771)
2. Fax to the number on its bottom
3. Follow up in three days.

MSP Opted In practitioners

To change your Teleplan Data Centre

1. Complete an  Application for Teleplan Service (HLTH 2820)
2. Fax to the number on its bottom
3. Follow up in three days.

Important:

Change your Data Centers when MSP Teleplan has none of your claims in process. To make this happen

1. Stop submitting any claims with your old Data Centre after the next close off date,
2. Receive remittance for that close off in your old software/old clinic
3. Start submitting your claims with your new software next day after the remittance.

Notes:

1. In forms HLTH 2771 and 2820, fill in subsection “Joining Existing Data Centre” in “Data Centre Informaiton” section. Enter the Data Center Number that you want to join in “Data Centre Number” field. If you don’t know the name of the Data Centre, leave it empty.
2. Disregard subsections “New Data Centre” and “Re-activate Previous Data Centre.”
3. Put a note anywhere on form HLTH 2771 or in a cover letter: “Please transfer me on [next day after upcoming remittance].”

If a Hard Opt Out practitioner works part-time at multiple locations and a clinic requires that the practitioner becomes Soft Opt Out on its premises, there is a way to become Soft and Hard Opt Out simultaneously.

Hot to become Soft and Hard Opt Out At Once

1. Complete an Application for an Additional MSP Payment Number (HLTH 2976) to obtain another MSP payment number
2. Sign an Agreement Between Medical Services Plan, Ministry of Health using your new MSP payment number
3. Complete an Application for Direct Bank Payment from Medical Services Plan (MSP) (HLTH 2832, optional)
4. Fax the signed forms to the numbers on their bottoms.
5. Follow up in three business days

After you set up your new payment number as Soft Opt Out, you can apply to join the clinic’s data center number to have your billing done through the clinic’s software. You will remain an MSP payee at that location.

If you want to make the clinic an MSP payee, inquire at Teleplan Support on whether you can do it while keeping your Hard Opt Out status at other places.

If you want to make a clinic an MSP payee, do an assignment of payments.

Who can do assignment of MSP payments

Almost any practitioner can assign his or her payments to another payment number. You can assign your payments to a payment number that belongs to a clinic, hospital or another practitioner. The only limitation is that assignments must be done within same billing option: Opted In or Opted Out. An Opted In practitioner cannot assign payments to a clinic with an Opted Out payment number. The same is true for Opted Out practitioner and Opted In clinic.

Who cannot do assignment of MSP payments

Hard Opt Out practitioners cannot make Assignment of Payments or be assignees of an Assignement, because they are never payees of MSP funds. That means that only Opted In and Soft Opt Out practitioners can assign their payments to a payment number with the same billing option.

How many assignments of payment can a practitioner have

A practitioner can have multiple assignments of payments for multiple places of work. Only claims that are submitted with a combination of a practitioner number and an assignee’s payment number are paid to the assigned payee. Other claims are paid to the practitioner.

How to overcome conflict in billing options

If an Opted Out practitioner wants to assign payments to an Opted In clinic, the practitioner needs to apply for a new payment number for that clinic. The number will obtain same billing status as the applying practitioner. The practitioner does not need to be an owner of the clinic to do so. Any practitioner can do it. After a clinic receives a new Opted Out payment number, all Soft Opt Out practitioners working at the clinic can make an Assignment of Payments to that number. The same applies to Opted In practitioners and Opted Out clinics. Read more in the section “Running a Clinic”.

A practitioner is not allowed to have two billing numbers with different billing options (Opted In and Opted Out), but a clinic is.

Who is exempt from an Assignment of Payments

A practitioner who applied for a clinic’s payment number does not need to complete an Assignment of Payment form because that payment number belongs to both the clinic and the practitioner. All claims submitted with the combination of practitioner number and clinic’s payment number will be paid to the clinic, while claims without clinic’s number will be paid to the practitioner. Claim Manager will take care of what numbers to use in which situation.

Hard Opt Out working for Soft Opt Out Clinics

If a Hard Opt Out practitioner works at multiple places and needs to make an Assignment of Payments to a Soft Opt clinic, he might be not be able to do so without converting to a Soft Opt Out option. Call Teleplan support and ask if applying for an additional Soft Opted Out payment number helps.

Additional Opt Out payment number definitely helps with being Hard Opt Out at one place and Soft Opt Out at another, but only when the practitioner remains the payee in both places. Read “Soft and Hard Opt Out Simultaneously” to learn more.

A Teleplan Data Centre and an Assignment of Payments

Is it possible to have both an MSP Teleplan Data Center and an Assignment of Payments? Yes, it is. If you want to remain an MSP payee in some locations and designate different MSP payees in others, you need to do both. Open an MSP Teleplan Data Centre to bill for locations where you remain an MSP payee and make Assignment of Payments to bill for locations where a payee is different. You can have multiple Assignments of Payments, but you only need to have one MSP Teleplan DCN to do billing for multiple locations.

What is the maximum term of assignment

The maximum term of assignment is five years. It can be terminated prematurely if practitioner leaves the clinic sooner.

Pros and Cons of Assignment of Payment

Pros

• Clinic collects all revenues and bears expenses including practitioners’ payroll
• Practitioners can make multiple assignments without opening additional payment numbers (within their billing option);

Cons

• Practitioners can delegate MSP billing but cannot remain MSP payees
• An assignment needs to be renewed at least every five years

How to make an Assignment of Payments

To make an Assignment of Payments

1. Complete Assignment of Payment Due to Practitioner under the Medical Service Plan (HLTH 2870)
2. Fax it to the number on its bottom
3. Follow up in three business days

You can read more about an Assignment of Payments here.

How to make a clinic an MSP Payee

To make a clinic an MSP payee you need to obtain an MSP payment number for your clinic. After it is issued, all practitioners need to assign their MSP payments to that number.

WHO CAN APPLY FOR A CLINIC’S NUMBER

A practitioner does not need to be an owner of a clinic to apply for its payment number. Any involved licensed practitioners can do it. An owner of the clinic can apply for the payment number only if the owner is a licensed practitioner.

Who owns clinic’s payment number

An applying practitioner is considered the owner of an issued number; no additional forms are required to designate his or her payments to that payment number.

What payments can be collected to clinic’s payment number

MSP, ICBC and WorkSafeBC payments of all practitioners working at a clinic can be collected to a clinic’s payment number if they instruct MSP to do so.

Clinic’s payment number and bank account

An owner of a clinic’s payment number can request to receive all MSP, ICBC and WorkSafeBC payments into a clinic’s bank account. In an absence of the request, payments come as cheques made out to a clinic’s name. If an application for a clinic number did not contain clinic’s name or had a mistake, cheques will be issued in a wrong name. They might be declined by a clinic’s bank. Always check clinic’s name on MSP records before you submit your claims in absence of direct bank payments.

Clinic’s billing Option

The clinic’s payment number will have the same billing status as the practitioner who applied for that number. That means that if an application is filed by an Opted Out practitioner, a clinic will be Opted Out, too. The same goes for Opted In.

Who can assign their payments to the clinic

Only practitioners with the same billing option can assign their payments to a clinic’s MSP payment number. Opted In practitioners cannot assign their payments to an Opted Out clinic and visa versa.

How to overcome a conflict in MSP billing options

If your clinic employs both Soft Opt Out and Opted In practitioners, it needs to obtain both Opt Out and Opt In payment numbers. After you receive two payment numbers for your clinic, Opted In practitioners will assign their payments to one number and Soft Opt Out to another. All payments can be collected to same bank account.

Hard Opt Out are excluded fom Assignment of Payment

Hard Opt Out practitioners cannot assign their MSP payments because they never receive them.

How to make a clinic an MSP payee for Opted In or Soft Opt Out practitioners

To obtain a clinic’s MSP payment number (Opt In or Soft Opt Out)

1. Complete Application for Additional Payment Number (HLTH 2976).
2. Attach a letter from your professional association that states that it recognizes your clinic.
3. Fax the papers to the number on the bottom of HLTH 2976
4. Follow up in a week.

Notes:

1. In section C check off “Fee For Service”.
2. In section E enter the date when you want to start using your new clinic’s MSP billing number. It can be a current or a future date.
3. In section D indicated a Teleplan DCN of the applying practitioner if attached
4. A clinic’s billing option depends on billing option of applying practitioner.

If no Teleplan DCN is indicated in section D of HLTH 2976,

1. Complete an Application for Teleplan Service (HLTH 2820) for Opted In clinic and/or
2. Complete an Application for Teleplan Service (HLTH 2771) for Opted Out Clinic
3. Fax to the number on its bottom
4. Follow up in three days.

To apply for a direct bank payment for clinic’s payment number (optional)

1. Add an Application for Direct Bank Payment from Medical Service Plan (MSP) HLTH 2832.

To make assignments of payments, ask practitioners to

1. Complete Assignment of Payment Due to Practitioner under the Medical Service Plan (HLTH 2870) for each practitioner (except for an owner of the clinic’s payment number)
2. Fax to the number on its bottom
3. Follow up in three days.

Notes:

1. Any Opt In or Soft Opted Out practitioner working at a clinic can apply for an Opt In or Soft Opt Out payment number for the clinic. No Assignment of Payment (step 4) is necessary for that practitioner.
2. All assignments of payments must be done within same billing options. Opted In practitioners must assign payments to an Opt In clinic’s number; Soft Opt Out practitioners – to Opted Out. Apply for MSP numbers with both billing options if you have both types of practitioners.
3. A practitioner is Soft Opt Out if he or she signed an Agreement with MSP.
4. Use your new clinic’s payment number in all forms. Make sure that clinic’s name in MSP file matches the name on clinic’s bank account.

How to make practitioners MSP payees

To make practitioners payees of MSP payments, clinic needs to obtain a shared Teleplan Data Centre. Claims submitted via such Data Centre will be paid directly to practitioners. Clinic does not need to obtain an MSP payment number for this setup. All practitioners will be treated as solo practitioners by MSP.

Who can bill MSP via a Shared Teleplan Data Centre

All billing options can bill Teleplan via a shared MSP Teleplan Data Centre: Opted In, Soft Opt Out and Hard Opt Out.

Claim Manager and a Shared Teleplan Data Centre

Claim Manager supports shared Teleplan Data Centre setup. All practitioners obtain individual accounts to a shared billing and patient management system. They can login from multiple devices with various operating systems and do their billing and patient management simultaneously. A receptionist mode when a receptionist can submit claims for all practitioners under his or her own account is supported. A shared Teleplan Data Centre can be used to bill for services performed at mulitple locations.

Shared Banking Account

 

To accumulate all MSP payments on a single banking account

1. Open a shared account
2. Have every practitioner to complete Application for Direct Bank Payment from Medical Services Plan (MSP)

How to make practitioners MSP payees

To make practitioners MSP payees

1. Have one practitioner apply for a Teleplan Data Centre Number

• Complete Application for Teleplan Service (HLTH 2820) for Opted In practitioner or
•  Complete Application for Teleplan Service (HLTH 2771) for Opted Out practitioner

2. Have all practitioners join that Data Centre

• Complete Application for Teleplan Service (HLTH 2820) for Opted In practitioners and
•  Complete Application for Teleplan Service (HLTH 2771) for Opted Out practitioners

Notes:

1. Any practitioner can apply for a shared Teleplan Data Centre, either Opted In or Opted Out.
2. Any practitioners can join a shared Teleplan Data Centre, either Opted In or Opted Out.
3. Opted In practitioners shall use form HLTH 2771. Opted Out practitioners shall use form HLTH 2820.
4. At step 1, fill in subsection “New Data Centre” in “Data Centre Information” section.
5. At step 2, fill in subsection “Joining Existing Data Centre” in “Data Centre Information” section. Indicate the Data Centre Number obtained after step 1 in that column.

Who can request a Direct Bank Payment from MSP

Opted In and Soft Opt Out practitioners can request to receive their MSP, ICBC and WorkSafeBC payments to their bank accounts. Hard Opt Out practitioners cannot make such a request.

How to request a direct bank payment from MSP

1. Complete Application for Direct Bank Payment from MSP (form HLTH 2832)
2. Fax it to the number on the bottom
3. Follow up in three business days.

Who receives MSP payments by cheques

Hard Opt Out practitioners always receive MSP, ICBC and WorkSafeBC payments by cheques. Their MSP cheques are issued in patients’ names, so they need to bill patients full amounts. Their ICBC and WorkSafeBC cheques made out to practitioners’ names.

The Online MSP form allows practitioners to request the cheques to be mailed to their care. Teleplan users do not have this option, which is not an issue since the cheques are always issued in patients’ names and cannot be deposited into clinic’s accounts.

Opted In and Soft Opt Out practitioners receive payments by cheques if they have not requested a direct bank payment. Their cheques are issued in the name of a payee, indicated on claims. That means that if they submit claims under an Assignment of Payments, cheques are issued in the name of an assignee. If they submit claims with no assignment, cheques are issued in their names.

Opted In and Soft Opt clinics receive payments by cheques if they have not requested a direct bank payment. Their cheques are issued in a name indicated on a clinic’s application for an MSP payment number. Double check your clinic’s name on MSP file lest your clinic’s bank refuses to deposit cheques made out to a different name.

Soft Opt Out practitioners can change to Hard Opt Out status while staying with Teleplan. A change in billing option does not require a change in Teleplan registration, which means you can keep your current Teleplan Data Centre Number.

How to Change from Soft to Hard Opt Out

1. Fax a free-form letter to MSP Teleplan recanting your Agreement with MSP  and asking to transfer you to Hard Opt Out status effective a certain day.

Notes:

1. Discuss the best date of changing your billing options with Teleplan support. It might be convenient to do it on a day following a close off.
2. Start charging your MSP Premium Assistance patients full amount on a day of transfer, not sooner and not later.
3. Payments for the services performed before a transfer day will come to your bank account or as cheques in your name. Payments for services after a transfer day will come to patients issued in their names.
4. You don’t need to change your Teleplan Data Centre Number if you change your MSP billing option. If you use Claim Manager, just mark the change of your billing option in your User Setup.

Hard Opt Out practitioners can change to Soft Opt Out status while staying with Teleplan. A change in billing option does not require a change in Teleplan registration, which means you can keep your current MSP Data Centre Number.

How to Change from Hard to Soft Opt Out

1. Become a payee of MSP payments

• Complete Agreement with MSP

2. Request direct bank deposits for MSP payments (optional)

• Complete Application for direct bank payment from MSP (HLTH 2832)

Fax the form to the number on its bottom. Follow up in three business days.

Notes:

1. The date on your agreement is important because it marks the day of your transfer. Discuss the best date of changing your billing options with Teleplan support. It might be convenient to do it on a day following a close off.
2. Stop charging your MSP Premium Assistance patients full amount on a day of transfer, not sooner and not later.
3. Payments for the services performed after a day of transfer will come as cheques in your name or to your bank account if you completed step 2. Payments for services before the day of transfer will come to patients issued in their names.
4. You don’t need to change your Teleplan Data Centre Number if you are changing your billing options. If you use Claim Manager, just mark the change in your User Setup.

Opted In practitioners can change to Soft Opt Out status while staying with Teleplan. A change in billing option does not require a change in Teleplan registration, which means you can keep your current MSP Data Centre Number.

How to Change from Opt In to Soft Opt Out

1. Fax a free-form letter to MSP Teleplan support asking to change your billing option from Opted In to Opted Out starting from certain date.
2. Remain a payee of MSP payments under your new Opted Out option
   • Complete Agreement with MSP

Fax the correspondence to the MSP Teleplan support number (indicated on forms’ bottoms). Follow up in three business days.

Notes:

1. The date of the change in your billing option is important. Discuss the best date with Teleplan support. Date both documents with the same date.
2. Start charging your MSP Premium Assistance patients over $23 after your transfer is complete. Until then, keep your fees to $23.00.
3. There will be no change in the form of MSP payments. If you had a Direct Bank Deposit, MSP payments will keep coming into your bank account.
4. You don’t need to change your Teleplan Data Centre Number. If you use Claim Manager, just mark the change of your billing option in your User Setup.

Patients Eligible for MSP supplementary benefits

Eight patient groups qualify for MSP supplementary benefits. The biggest one is MSP Premium Assistance Recipients.

MSP Premium Assistance Recipients

MSP Premium Assistance status is granted to low-income B.C. residents on their request. MSP Premium Assistance Recipients qualify for MSP supplementary healthcare benefits and discounted MSP premium rates. It is estimated that in the year 2012/2013 about 1,000,000 of B.C. residents qualified for MSP Premium Assistance.

To qualify for this status a patient needs to have an annual adjusted net family income of less than $30,000. There is a formula that helps patients to determine if they qualify, but many patients fail to do so. Take a minute to familiarize yourself with this government program, so that you can learn to identify potentially eligible patients and educate them about their rights.

The 30,000 annual family limit might appear as a tight limit to qualify, but the key words here are net and adjusted. Net means an income after allowable expenses, which is relevant if you patients are self-employed. Adjusted means that net income is further decreased by allowable deductions for spouses, senior age, children, universal child care benefits and disability. The deductions raise limit in relation to patients’ gross income.

To make your services more affordable to your patients

• Print out a stock of Medical Services Plan Application for Regular Premium Assistance forms to give away to your patients
• Print out a stock of Monthly MSP Premium Rates  to show how much you patients can save on MSP premiums
• Learn more about MSP Premium Assistance program, including Regular and Temporary Premium Assistance.

Advertise your service to eligible patients on your website and use it as a educational tool, as well.  Educate your receptionists to share the information about the program with your patients and include it in your Welcome package.

Other patient groups eligible for MSP supplementary benefits

MSP Premium Assistance Recipients are not the only group that is eligible for MSP supplementary benefits. Other groups include

• Income Assistance recipients
• Convention refugees
• Inmates of B.C. Correctional Facilities
• Individuals enroled with MSP through the At Home Program
• Residents of long term care facilities receiving the Guaranteed Income Supplement (GIS)
• Individuals enroled with MSP as Mental Health Clients and
• First Nations individuals with valid B.C. Medical Plan coverage through the First Nations Health Authority.

For simplicity, wee will use the term MSP Premium Assistance patients to refer to all groups to MSP supplementary benefits patients. We will also refer to them as Eligible MSP patients or just MSP patients.

Learn to identify all these groups. Including MSP supplementary benefits patients in your circle of patients will grow your practice and help expand your healing touch.

MSP Fee Schedule for supplementary healthcare benefits

MSP set up the following fee schedule for supplementary healthcare practitioners*:

00142 – Acupuncture service, $23.00
09948 – Massage therapy service, $23.00
00138 – Chiropractic service,  $23.00
00145 – Naturopathy services, $23.00
09938 – Physiotherapy service, $23.00
00189 – Non-Surgical Podiatry Visit, $23.00

* All services are benefits up to a combined maximum of 10 visits per patient per calendar year.

What Services Count Towards an Annual Limit

An annual limit of ten combined visits includes services provided by licensed supplementary benefits practitioners such as acupuncturists, massage therapists, chiropractors, physiotherapists, naturopathic physicians, and podiatrists.

Eligible MSP patients

Only groups listed in section MSP Premium Assistance Patients on this page may qualify for MSP coverage. Regular MSP patients pay full charge.

Premium Assistance Benefits are Exhausted

After an annual limit of ten visits is exhausted, MSP Premium Assistance patients pay full charge.

Change in MSP Eligibility

MSP Premium Assistance status can expire midyear after the Canada Revenue Agency releases income information to the Ministry of Health and/or Health Insurance BC from the person’s tax returns. That means that patients’ eligibility for MSP benefits can change midyear before the ten visits are exhausted.

MSP Eligibility Check

Claim Manager can verify MSP eligibility of a patient in real time on a current or past date. Because there is a two-week delay in MSP claim processing, the eligibility report might be inaccurate, especially in the year end, because some submitted claims might not be accounted for.

When to submit MSP claims

You have 90 days to submit your MSP claims, but we recommend that you do it on a day of service. The claims are processed on first-come, first-processed basis, not on the basis of earlier service date. If you procrastinate, somebody else can beat you to a remaining limit. Prompt claim submission increases collection rate of your MSP claims.

Who can bill ICBC via Teleplan

Only physiotherapists and chiropractors on a fee-for-service ICBC schedule are allowed to bill ICBC via Teleplan. Chiropractors on the ICBC flat fee program must bill ICBC directly.

Who can bill WorkSafeBC via Telelpan

RMTs, chiropractors and physiotherapists are allowed to bill WorksSafeBC via MSP Teleplan.

Billing option and ICBC and WorkSafeBC Billing

A billing option does not make a difference for ICBC or WorkSafeBC billing except for Hard Opt Out practitioners. MSP does not support direct bank payments for Hard Opt Out practitioners, so they receive their ICBC and WorkSafeBC payments as cheques made out to their names. Unlike their MSP remittance reports and payments that come only once a month, their ICBC and WorkSafeBC payments come twice a month in accordance with MSP Payment Schedule.

Who receives ICBC and WorkSafeBC payments

All ICBC and WorkSafeBC payments go to practitioners. They never go to patients. With an Assignment of Payments, payments go an assignee, which might be a clinic, hospital or another practitioner.

Who can apply for direct bank payments from ICBC and WorkSafeBC

Only Soft Opt Out and Opt In practitioners can receive their ICBC and WorkSafeBC payments directly to their bank account. Hard Opt Out practitioners will receive payments as cheques issued in their names.

How often do ICBC and WorkSafeBC Payments come

ICBC and WorkSafeBC payments come in accordance with MSP Payment Schedule. All billing options, including Hard Opt Out, receive ICBC and WorkSafeBC payments twice a month.

Who can bill WorkSafeBC patients directly

Most practitioners are prohibited from billing their WorkSafeBC patients directly. They have to comply with WorkSafeBC Fee Schedule for their profession and they must submit all their invoices to WorkSafeBC.

Who can bill ICBC patients directly

If ICBC Fee Schedule does not cover treatment fees, the remainder of the fees is often billed to patients or to patients’ extended insurance plans.

Who can bill MSP using the MSP Online Form

Opted In and Hard Opt Out practitioners who submit claims for fewer than 2,400 services per year and earn less than $72,000 annually in fee-for-service payments have an option to submit their claims free of charge via the MSP Online Form. The only ostensible advantage of this tool is lack of charge. The disadvantages are many. We do not recommend to bill MSP with this form, but if you want to you can do it by following the links:

Opted In practitioners – the Pay Practitioner online form.

Hard Opt Out practitioners  – the Pay Patient claim form.

THE GOOD, BAD AND UGLY OF  THE MSP ONLINE FORM

The Online Claim Form lacks integration with a patient management system or, simply put, it does not come with a database that records your entries and keeps track of submitted claims. Because it does not remember which patients are billed for and which claims are submitted, practitioners need to track their accounts receivable themselves. All declined claims must be created anew to be resubmitted.

Another disadvantage of the Form is that it is a one-way communication. It passes information to MSP but does not return a real-time reply to a practitioner. A report about claims’ errors comes by mail with a delay of two weeks (Opted In) to a month (Hard Opt Out). The MSP remittance report also comes on paper and have to be reconciled manually. MSP Teleplan, for comparison, provides for an electronic error report within 24-hours, MSP eligibility report instantly and MSP messages nightly. All electronic communication from MSP Teleplan is matched to claims in your patients’ management system, automating payments’ reconciliation and claims resubmission.

As MSP Online Form remembers no entries, claim creation is laborious. Each entry starts with an empty screen with no patient search, autosuggestion or built-in catalogs. In short, the tool helps neither create a claim nor track its progress throughout MSP adjudication process. A better way to do MSP billing is with MSP Teleplan.

MSP ONLINE FORM AND PAYMENT METHODS

Like Teleplan users, Opted In users of the MSP Online Form receive payments twice a month. They qualify for Direct Bank Payment form (HLTH 2832). In its absence, payments are mailed as cheques.

Hard Opt Out users of the MSP Online Form receive payments once a month. They receive cheques that are always issued in patients’ names. MSP cheques are usually mailed to patients’ homes. Practitioners can request to receive cheques to their care with intention to deposit them into their bank accounts; however, banks rarely accept such cheques.

MSP Teleplan is the best way to bill MSP, ICBC, WorkSafeBC.

Teleplan is the best way to bill MSP, ICBC and WorkSafeBC. It is a two-way electronic communication system that can be integrated with a patient management system such as Claim Manager. Sophisticated integration allows for many benefits and time saving tricks that are not obtainable with online or paper forms, such as data validation, daily error reports, easy claim correction and re-submission, automatic tracking of accounts receivable, semi-monthly payments, built-in catalogs, auto-fill, autosuggestion, sticky data and instant verification of names’ spelling and MSP payment eligibility, including verification on past dates of service. MSP Teleplan is the only recommended way to do MSP, ICBC and WorkSafeBC billing for practitioners who have Internet access.

OPTED IN AND PAPER FORMS

If practitioners can demonstrate that they reside in a community without Internet access or that obtaining Internet access will cause significant financial hardship, they can submit their claims via mail using a paper Claim Form. This form bears none of the advantages of Teleplan and all the disadvantages of the online form, but sometimes it is the only option you can use.