Telephone Advice Billings – FFS

Tuesday, 20 April 2010

BCMA

Fee ($)

MSP

Fee ($)

G10001 Specialist Telephone Advice – Initiated by a Specialist or General Practitioner, Urgent…………………………………………. 132.00 60.00
NOTES

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.

G10002 Specialist telephone patient management – initiated by a Specialist or General Practitioner, one week 88.00 40.00
NOTES

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 7 days of initiating physician’s request.  Initiation may be by phone or referral letter.

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 week.

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.

G10003 Specialist telephone patient management / follow-up 44.00 20.00
NOTES

i)          This fee applies to two-way direct telephone communication (including other forms of electronic verbal communication) between the specialist physician and patient, or a patient’s representative. Not payable for written communication (i.e. fax, letter, e-mail).

ii)         This fee is only payable for scheduled telephone appointments with the patient.

iii)       Access to this fee is restricted to patients having received a consultation, diagnostic procedure or surgical procedure from the same certified specialist physician, within the 6 months preceding this service.

iv)       Each physician may bill this service four (4) times per calendar year for each patient.

v)         Not payable in addition to another service on the same day, for the same patient by the same practitioner.

vi)        Telephone management requires two-way communication between the patient and physician on a clinical level; the fee is not billable for administrative tasks such as appointment notification.

vii)      No claim may be made where communication is with a proxy for the physician (e.g. nurse or assistant).

viii)     This fee requires chart entry as well as ensuring that patient understands and acknowledges the information provided.

ix)        Include start and end times in time fields when submitting claim.

x)         Cannot be billed simultaneously with salary, sessional, or service contract arrangements.

xi)        Out-of-Office Hours Premiums and Rural Retention Premiums may not be claimed in addition.