i) Payable to Specialist Physicians for two-way telephone communication (including other forms of electronic verbal communication) regarding assessment and management of a patient but without the consulting physician seeing the patient.
ii) Conversation must take place within two hours of the initiating physician’s request. Not payable for written communication (i.e. fax, letter, e-mail).
iii) Includes discussion of pertinent family/patient history, history of presenting complaint, and discussion of the patient’s condition and management after reviewing laboratory and other data where indicated.
iv) A chart entry, including advice given and to whom, is required.
v) Include start and end times in time fields when submitting claim.
vi) Not payable for situations where the purpose of the call is to:
a) book an appointment
b) arrange for transfer of care that occurs within 24 hours
c) arrange for an expedited consultation or procedure within 24 hours
d) arrange for laboratory or diagnostic investigations
e) inform the referring physician of results of diagnostic investigations
f) arrange a hospital bed for the patient
vii) Limited to one claim per patient per physician per day.
viii) Out-of-Office Hours Premiums and Rural Retention Premiums may not be claimed in addition.
ix) Not payable to physician initiating call.
x) Not payable in addition to another service on the same day for the same patient by same practitioner.
xi) No claim may be made where communication is with a proxy for either physician (e.g. nurse or assistant).
xii) Cannot be billed simultaneously with salary, sessional, or service contract arrangements.