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 […]