The MOHLTC has recently announced that they have rolled out three new billing codes that will enable physicians to de-roster patients without having to submit the “Primary Care – Request to Remove a Patient” forms.

What are the De-Roster Codes Implemented?Stethoscope

  • Q401A – De-Roster – Member Deceased.
  • Q402A – De-Roster – Ended by Provider.
  • Q403A – De-Roster – Patient Left Province.

How do we bill the new De-Roster Q Codes?

  • Ensure the Service Date inputted when billing matches the effective De-roster Date you wish to remove the patient to.
    • The usual six-month stale dating rule that applies to all claim submissions applies to the De-Roster Q codes.
  • The De-Roster Q codes may be submitted with a service date of up to six months prior to February 1st, 2017 (therefore August 1st, 2016).
  • Physicians who have submitted de-roster forms with an end date after August 1st, 2016 and within the 6-month stale-dating period may submit the De-Roster Q codes or wait for their forms to be processed.
    • Ensure the service date when billing the Q code matches the de-roster date noted on the paper copy of the de-roster form.
    • Per the MOHLTC, should the de-roster date be greater than 6 months from the date the claims are being billed for submission, then you must contact your Claims Services Branch office and request approval to submit a stale dated claims file for these claims. Approval must be received prior to submitting the stale dated claims file.
  • Physicians who have submitted de-roster forms with an end date prior to August 1st, 2016 must wait to have their form processed.

Please note that the MOHLTC will continue processing paper de-roster forms until April 1st, 2017 only.

Further information on the MOHLTC changes is available via the Bulletin here.

If you have any questions about the above information, please fill in the form below and a Cirrus healthcare consultant will be in touch with you shortly.