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Payment Schedule for Insured Services Provided by a Physician

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Payment Schedule for Insured Services Provided by a Physician Payment Schedule For Insured Services Provided by a Physician October 1, 2017 Payment Schedule for Insured Services Provided by a Physician October 1, 2017 Page 2 Payment Schedule for Insured Services Provided by a Physician TABLE OF CONTENTS Introduction 7 Services Provided Outside Saskatchewan • Out of Canada Services 9 • Out of Saskatchewan Services 9 • Coverage for Services Unavailable in Canada 9 Billing For Services Provided To Out-Of- 10 Province Beneficiaries Definitions 11 Documentation Requirements 15 Assessment Rules • Introduction 16 • Visits 17 • Hospital Care 17 • Consultations 18 • Procedures 20 • Multiple Services – General Assessment Rules 22 General Information • Services Supervised by a Physician 25 • Submission of Accounts 26 • Location of Service Indicators 28 • Out of Province Patients 29 • Practise Entirely Outside the Medical Care Plan 29 • Special Contracts 29 • Patient Identification 29 • Temporary Health Coverage 30 Services Not Insured 31 Assessment of Account 34 Verification Program 35 Information Sources • Claims Analysis Unit 33 • Processing Support 36 • Medical Consultant 36 • Financial Services 37 • Casework 37 • Policy, Governance and Audit 37 • eHealth - Technical Issues 37 • Fee for Services & Statistics 38 Reciprocal Billing • For Patients from Other Provinces 39 • Physician Services Excluded from Reciprocal billing 40 Explanatory Codes for Physicians 41 October 1, 2017 Page 3 Payment Schedule for Insured Services Provided by a Physician October 1, 2017 Page 4 Payment Schedule for Insured Services Provided by a Physician LIST OF INSURED SERVICES, PROCEDURES AND VISITS Miscellaneous Services Section A General Practice Section B Pediatrics Section C Internal Medicine Section D Psychiatry Section E Dermatology Section F Medical Genetics Section G Anesthesia Section H Cardiology Section I Surgical Assistant Section J Neurosurgery Section K General Surgery Section L Orthopedic Surgery Section M Plastic Surgery Section N Physical Medicine Section O Obstetrics and Gynecology Section P Neurology Section Q Urological Surgery Section R Ophthalmology Section S Otolaryngology Section T Pathology Section V Diagnostic Ultrasound Section W Diagnostic Radiology Section X Therapeutic Radiology and Nuclear Medicine Section Y October 1, 2017 Page 5 Payment Schedule for Insured Services Provided by a Physician October 1, 2017 Page 6 Payment Schedule for Insured Services Provided by a Physician INTRODUCTION 1. This Payment Schedule is effective for services provided on and after October 1, 2017. It lists a payment for each insured service which will be made at 100% unless the "Assessment Rules" indicate that payment for the service: a) is included in the composite payment made for another service; or b) is subject to an adjustment when billed in addition to another service. 2. Medical Serivces Branch has the authority to pay physicians for medically required services. The Saskatchewan Medical Care Insurance Act, 14 (1) states: Subject to sections 15 and 24, services that are medically services provided in Saskatchewan by a physician are insured services. 3. Physicians who have entered into a Direct Payment Agreement with the Ministry of Health, which sets the payment for each service, must bill services to Medical Services Branch in accordance with the Payment Schedule: The Saskatchewan Medical Care Insurance Payment Regulations 1999 2000, c. S-29, Reg. 19, stipulates at 6(1)(d) that: 6 (1) Where an insured service is provided in Saskatchewan to a beneficiary by: (d) a physician, the minister shall make payment for that service in accordance with the physician payment schedule and the assessment rules contained in that schedule. 4. All services billed to Medical Services Branch are the sole responsibility of the physician rendering the service with respect to appropriate documentation and billing (see also “Documentation Requirements for the Purposes of Billing”). 5. If a specific fee code for the service rendered is listed in the Payment Schedule, that fee code must be used in claiming for the service, without substitution. 6. When a physician service is not listed in the Payment Schedule, the physician should write Medical Services Branch to request advice on the correct submission of the account: 3475 Albert Street, Regina SK, S4S 6X6 or fax 306-787-3761. Your correspondence must outline: 1. The nature and description of the service; 2. The frequency of the service; 3. The length of time spent performing the service; and 4. The suggested fee and rationale. October 1, 2017 Page 7 Payment Schedule for Insured Services Provided by a Physician INTRODUCTION 7. When unusual time, skill or attention is required in the management of any medical condition, a payment greater than the amount indicated in the Payment Schedule may be authorized upon receipt of a written report. To request consideration of payment, please write to: Medical Services Branch, 3475 Albert Street, Regina SK, S4S 6X6 or fax 306-787-3761. Your correspondence must outline: 1. The nature and description of the service; 2. The frequency of the service; 3. The length of time spent performing the service; and 4. The suggested fee and rationale. October 1, 2017 Page 8 Payment Schedule for Insured Services Provided by a Physician SERVICES PROVIDED OUTSIDE SASKATCHEWAN 1. Out-of-Canada Services a) Non-emergency (elective) services are only considered in exceptional circumstances and must have prior approval from the Ministry of Health. b) Emergency services -- Saskatchewan rates of payment apply and prior approval is not required 2. Out-of-Saskatchewan Services a) Prior approval is not required for the vast majority of physician services received in other provinces and territories as long as these services are provided within the publicly funded health care system. b) If an insured service is unavailable in Saskatchewan, it should be sought in another province. c) Patients will not be billed for most services they receive in other provinces and territories. d) Quebec is an exception; patients may have to pay for physician services in Quebec and submit a bill to the Ministry of Health for payment at Saskatchewan rates. 3. Coverage for Services Unavailable in Canada When an insured service is unavailable in Canada, special rates of payment may apply when the following conditions are met: a) A Saskatchewan listed specialist, within whose field of practice the required service lies, submits a written application for Ministry consideration of request for coverage of medical services unavailable in Canada to: Director, Insured Services Medical Services Branch, Ministry of Health 3475 Albert Street, Regina, Saskatchewan S4S 6X6 b) The written application is made prior to referral of the patient for treatment outside Canada; c) The application must state: • the patient's name, address and valid Health Services Number; • pertinent clinical details and diagnosis; • the nature of the service required and confirmation by the specialist that, to the best of his knowledge, the service(s) being requested is not obtainable within Canada; • where possible the name and location of the physician who is to provide the service d) Prior approval must be obtained from the Ministry of Health’s Medical Services Branch. The Ministry’s decision regarding the coverage request and the rate of payment to apply is provided in writing to both the referring specialist and the beneficiary. October 1, 2017 Page 9 Payment Schedule for Insured Services Provided by a Physician SERVICES PROVIDED OUTSIDE SASKATCHEWAN BILLING FOR SERVICES PROVIDED TO OUT-OF-PROVINCE BENEFICIARIES 1. With the exception of patients from Quebec, Saskatchewan physicians should submit their accounts for insured services provided to any Canadian resident to Medical Services, Ministry of Health, for processing at Saskatchewan rates. 2. Certain items excluded from the Reciprocal Billing Agreement may be insured by the beneficiary’s home province. It is suggested that in such cases a letter of inquiry be forwarded to the beneficiary's provincial plan for clarification. October 1, 2017 Page 10 Payment Schedule for Insured Services Provided by a Physician DEFINITIONS 1. Age Categories a) Premature -- a child weighing 2.2 kg or less; b) Newborn -- a child in the first 10 days of life; c) Infant -- a child in its first year of life; d) Child -- any person under thirteen years of age, except where noted otherwise e) Adult -- a person who has attained the age of 13 years; except where noted otherwise. 2. Classifications Designates the time span applied by the Assessment Rules to other services in arriving at an appropriate payment. a) Diagnostic -- the day of the procedure; b) "0" Day -- the day of the procedure; c) "10" Day -- the day of and ten days following the procedure; d) "42" Day -- the day of and forty-two days following the procedure. 3. Clinic The arrangement whereby two or more physicians are practising their profession, medical records and histories of the patients of those physicians are being maintained, and each of those physicians has access to those medical records and histories. 4. Composite A payment which includes the payment for more than one service associated with the treatment of a condition 5. Fee for Service Services are to be billed on the basis of the individual appropriate visit or procedure items included in the Payment Schedule at the listed amount and are subject to the Assessment Rules. 6. By Report The claim must be made on one of the regular claim forms (not by automated submission) and must be accompanied by a detailed explanation of the circumstances and the services provided. Payment will be assessed on the basis of the information provided. An estimated appropriate fee may be provided. 7. Hospital A hospital as defined in The Hospital Standards Act. 8. Palliative As defined by the Regional Health Authorities is a life-limiting/life threatening illness where the focus is on comfort rather than cure. The Drug Plan and Extended Benefits Branch of the Ministry of Health, further defines palliative as patients who are in the late stages of a terminal illness where life expectancy is measured in months.
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