Articles for Physicians

Buying a Family Practice in Ontario

Important Questions and Issues to Consider:

Benefits to Purchasing a FHO Practice:

It is the ideal time to purchase an established FHO practice; however, it’s important to consider the substantial time, commitment and costs involved. Although there is an initial upfront cost, the long-term benefits far outweigh the short-term investment, such as:

While the FHO model is the most popular payment model within family medicine, it can also be the most complicated. It is critical to your practice’s success, if you decide to use the FHO payment model, to ensure you are familiar with the “ins and outs” of practicing and optimizing a FHO practice from day one. Contact Cirrus to learn more about running a FHO practice.
Considerations in the Medical Office Lease:

As a physician looking to acquire a medical practice, it is also important to take proactive measures to ensure you are protected from potentially dangerous language in the medical office lease. Be sure to dig deep, and ask the selling physician about their lease obligations. One key question to ask is whether the office lease will be assigned to you, or, will you have to sign a new lease?

Evaluate important lease terms such as economics, critical dates, and any details and risks hidden throughout. Some significant lease terms include:

It is recommended to have the lease professionally reviewed before moving forward with your new practice venture. This will help ensure you are protected, while also providing the flexibility to continue to run and grow your clinic. The best way to do this is by seeking help from a healthcare leasing expert such as Cirrus Consulting Group for a professional, and thorough review of the details of your office lease.
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Selling a Family Practice in Ontario

When contemplating selling a FHO practice, there are many things to take into consideration. Here are some of the key questions and issues you’ll want to consider:

What is Your Practice Worth?

Attaching a value to your practice can sometimes be a difficult task as you may disagree with the market and its estimated worth. Ultimately, its worth depends on how much a buyer is willing to pay, the income generated by your practice month-to-month, and additional offerings that speak to the buyer in question.

Considerations in Your Medical Office Lease

There is so much at stake in the process of selling a family practice; therefore it is imperative that you consider the current obligations of your office lease, specifically the assignment provisions within it. Prior to completing the sale, it’s important to have your lease properly reviewed to ensure that there are no hidden risks, and that the ‘assignment of the lease’ occurs properly, protecting the interests of both parties along the way.

Communication with Your Colleagues

It is important to communicate with your colleagues to ensure that they are aware of the upcoming changes. This is important so you may gain their support along the way with regards to group obligations. When it comes to the MOHLTC, transitioning a healthcare practice has many steps involved. Make this process easier on yourself and look to the professionals for help.
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Allow Cirrus Consulting Group to help facilitate the sale and optimization of your practice.
Contact us for a complimentary consultation, or call 1.800.459.3413.

Preventive Care Bonus Submissions

Physicians may now submit their Preventive Care Bonus targets attained for the 2016-2017 MOHLTC fiscal year. Submissions are open from April 1st to the September 2017 claims submission cut-off date.
How do I calculate my Preventive Care Bonus threshold?
The goal is to calculate how many of your enrolled patients have 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 to Preventive Care Billing:

Make sure to bill your relevant Preventive Care Bonus code(s) and backdate it to March 31, 2017 to reflect your performance in the 2016-2017 fiscal year.
The MOHLTC Preventive Care Target Population/Service Report (Previous & Projected) was issued in late April 2017. This report can be used to assist you in calculating your target thresholds attained.
Another tool in managing and tracking your Preventive Care in the Colorectal, Cervical and Breast Cancer Screening categories is to sign up for the Screening Activity Report (SAR) by clicking here.

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.

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.