Articles for Physicians

New De-Roster Codes

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?

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 […]

Cirrus Special Premiums and Bonuses Update

A successful medical practice is built on a strong foundation and an understanding of the various revenue streams available to you.

Special Premiums & Bonuses are often overlooked when it comes to FHO revenue optimization. As part of the Cirrus mandate to ensure all potential revenue is captured for your practice by the end of the MOHLTC fiscal year, Cirrus will issue the Special Premiums and Bonuses Report prior to March 31st, 2017.

The report outlines your total premiums and bonuses attained year-to-date and compares your progress to your previous fiscal year performance to ensure you attain all bonus categories relevant to your medical practice.

Missed our latest informative webinar on capturing your Special Premiums? Access it at your convenience 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.

The Do’s and Don’ts of Setting Up a Locum Physician and Billings

Are you considering hiring a Locum to cover your practice?
Hiring a Locum physician is recommended anytime a FHO physician will be away from their practice for a significant period of time and/or their FHO colleagues cannot provide sufficient coverage during their absence. When registered properly with the MOHLTC, the Locum Physician will be able to submit billings on FHO enrolled patients, without incurring Outside Use to the signatory physician and their FHO group.

Where do the payments from the Locum’s billings go to?
In a common scenario where the FHO is setup such that individual physician billings go to their solo accounts and group funds into the group account, the funds are distributed as follows:

If you or your colleagues have any questions with regards to hiring locums attached to your FHO practice, do not hesitate to contact one of our Cirrus Physician Support Specialists.
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.

Changes to the New Graduate Entry Program (NGEP)

Effective May 2016, the MOHLTC has made amendments to the parameters of the NGEP for new graduates wishing to join or form a Family Health Organization (FHO).

Summary of Changes

Year 1: Up to $162,000 (~$13,500/month)
Year 2: Up to $178,000 (~$14,833/month)
Year 3: Up to $207,000 (~$17,250/month)

Interested in the NGEP or other FHO vacancies in Ontario?
Cirrus can help connect you with interested candidates and/or FHOs in the province, and manage the MOHLTC application & communication process on your behalf. Contact us for any available vacancies, and learn more about the updates to the NGEP program here.
Fill in the form below to contact a healthcare consultant for more information.

Preventive Care Bonus Submissions

Physicians in Ontario may now submit their Preventive Care Bonus targets attained in the 2015-2016 MOHLTC fiscal year. Submissions are open from April to September 2016.
How do I calculate my Preventive Care Bonus threshold?

The goal is to calculate how many of your enrolled patients received their preventive care services within the relevant screening intervals.

i.e. * 100%

You must then bill the appropriate billing code that corresponds to the percentage threshold reached in your preventive care efforts.
Cirrus Tips:

In order to ensure that you have been paid your bonus for the previous fiscal year, you may review your monthly Remittance Advice under the ‘Preventive Care Bonus Accumulations and Payment’ section in the months following submission.

For further assistance or clarification on accurately billing for your Preventive Care Bonus, please do not hesitate to contact your Cirrus Consultant at any time.
Fill in the form below to contact a healthcare consultant for more information.

Cirrus Special Premiums and Bonuses Update

A successful practice is built on a strong foundation and an understanding of the various revenue streams available to you.
Capture your Special Premiums
The Special Premiums and Bonuses are often overlooked when it comes to FHO revenue optimization. As part of our Cirrus mandate to ensure all potential revenue is captured for your practice by the end of the MOHLTC fiscal year, Cirrus will issue the Special Premiums and Bonuses Report prior to March 31st 2016. The report outlines your total premiums and bonuses attained year-to-date and compares your progress to last fiscal year to ensure you attain all bonus categories relevant to your practice.
Fill in the form below to contact a healthcare consultant for more information.

MOHLTC Roster and Capitation Payment Reconciliation Reports

We would like to remind you that the Ministry has released new Roster and Capitation reports available through MC EDT. These reports provide you with current information regarding which patients have come on and off your roster, as well as a full list of your enrolled patients.
Unsure of how to access these reports?
Cirrus can provide you with a monthly copy of your report through our Cirrus Physician Portal, if we have been assigned as Designated Users to your MC EDT account. Please contact our team to benefit from this value-add support tool.
Fill in the form below to contact a healthcare consultant for more information.

FHO Eligibility Update: New Graduate Entry Program

Part of Cirrus’ ongoing commitment to our physicians is to ensure you are kept up to date on all updates from the MOHLTC that may impact your practice.

The MOHLTC has announced a new program dedicated to ensuring New Graduate Physicians in Family Medicine have an opportunity to join Family Health Organizations (FHO) or Family Health Networks (FHN) in areas that are not designated as high-needs.
Eligibility:

High Level Program Overview:

— Year 1: 825 patients
— Year 2: 1000 patients
— Year 3: 1200 patients

Physician Remuneration:

— Year 1 – Up to $162,000
— Year 2 – Up to $178,000
— Year 3 – Up to $207,000

— In Year 1: $0
— In Year 2: $28,000
— In Year 3: $28,000
Further information on the MOHLTC changes is available via the Bulletin by clicking here.
Thinking of applying for the NGEP program or interested in bringing a New Graduate on board to join your FHO? Contact the Cirrus Team by filling in the form below and let us support you with your NGEP and FHO/FHN applications along with optimizing your practice.

Preventive Care Bonus Submission Deadline

Ensure you submit your Preventive Care Bonuses by September 18, 2015.
In order to ensure that you have been paid your bonus for the previous fiscal year, you may review your monthly Remittance Advice under the ‘Preventive Care Bonus Accumulations and Payment’ section of your Remittance Advice Report in the months following submission.

Ensure to bill your Preventive Care Bonus codes and backdate them to March 31, 2015 to reflect your performance in the 2014-2015 fiscal year.

The MOHLTC Preventive Care Target Population/Service Report will be issued in October 2015 which is updated to reflect mid-year changes to your target population and preventative care services provided. For further assistance or clarification, please do not hesitate to contact us.
Fill in the form below for a complimentary chat with a healthcare expert!

High Inside Use & Medical Billing Data Analysis

Ever wonder how many of your patients are over using your services?
Cirrus has developed a “High Inside Use & Billing Analysis” that will further support you in optimizing your medical practice. We identify enrolled patients heavily using your services by way of a cost-benefit analysis, entitling you to adjust your roster accordingly. In addition, the analysis will ensure that you are billing key areas often misbilled by family physicians, and getting paid for the care that you provide. For further information on this new analysis, please contact a Cirrus Consultant by filling out the form below to discuss how this service can help you and your practice.