Reduce administrative burden and get compensated properly for your time
Your time is valuable – and your patients aren’t the only ones who want access to it.
Employers, insurance companies, government agencies and other third parties may all look to you for medical expertise and guidance about patients under your care.
Whether small or time-consuming, these requests often can’t be billed to OHIP. That can leave you with an extra, unpaid administrative burden.
As with many other types of uninsured services, you need to know what your rate should be and ensure you’re compensated fairly, says Toronto family physician Dr. Ryan Banach.
“Value yourself,” he explains. “Value your time.”
In a recent webinar for OMA members, Dr. Banach described his tips for handling third-party billing requests, based on what he’s learned from 16 years of medical practice.
You can bill many types of third-party requests, such as forms and letters, medical-legal reports, and physical exams initiated by a third party. Whoever makes the request should pay for the service.
The OMA’s guide to uninsured services lists suggested rates for common requests, as well as a multiplier to calculate proper payment for services normally covered by OHIP.
However, Dr. Banach says some services aren’t billable. In addition to normally unbillable services (such as medical record-keeping or requesting referrals), certain government-related forms can’t be billed. These are listed in the uninsured services guide.
If you know the visit is for a third-party service, you can’t bill it to OHIP, Dr. Banach says. This holds true whether the patient tells you before, during or after their visit.
There are billing considerations around certain types of visits, such as WSIB claims or TB tests. Consult the OMA’s uninsured services guide for more.
To prevent any surprises, he recommends getting more information up front from patients, so you or your staff can set expectations and communicate clearly.
Many insurance and legal requests can involve lengthy forms, in-depth analysis of charts and additional patient examinations.
When you receive this type of request, Dr. Banach recommends you provide the third party with a detailed estimate of the time needed to fulfil it, using your official letterhead. (You can find a letterhead template in our operations and practice management resource hub.)
Be sure to factor in all time spent writing reports, researching and making phone calls, as well as any other costs like materials and couriers for documents.
Once this is authorized by the third party, create a detailed, professional invoice on your letterhead that includes an interest charge for any unpaid accounts. You can find a template in our operations and practice management resource hub.
Cash payments are always welcome, Dr. Banach says, but many prefer to use a card. He recommends a point-of-sale system, or there are other mobile apps that can process payments.
He also recommends having a conversation with an accountant about the ins and outs of charging HST and other business-related details.
No matter what systems you use, Dr. Banach says it’s important to collect payment at the time of service whenever possible so you don’t need to chase down unpaid accounts.
“I’m not a bill collector,” he says. “I’m a doctor, so I focus on patient care.”
