Examining collegiality in Saskatchewan - Saskatchewan Medical ...

More documents

Recommendations

Info

Physician sings high praise for billing review session By Doré Collett In January, Dr. Eben Strydom contacted SMA News Digest with high praise for a workshop he had just attended about correct billing of services. He wanted to share specifics with his colleagues that he found were particularly interesting and useful. Charlene Koch, a field officer with Saskatchewan Health’s Medical Services Branch, presented the session in Melfort that Dr. Strydom attended. “It is always great to hear that the billing review sessions are beneficial,” explained Ms. Koch, who was on her way to Maidstone, Lloydminister, and then North Battleford to conduct similar sessions. The GP billing review session covers a variety of items, including: physician responsibilities, the payment schedule, assessment rules, explanatory codes, a claims processing overview, frequently used codes, a review of payments, and common billing scenarios. Throughout the sessions, which typically run 2.5 hours, she provides plenty of opportunity for Q&A. Participation by physicians and billing staff adds to the learning experience. Of her experience with the sessions so far, Ms. Koch expresses that “the physicians always say that they take away something new that they didn’t know previously, or the session reminded them of something they used to know but have since forgotten.” The field officer role is a key resource for physician billing information. In addition to the sessions offered, Ms. Koch meets with individual physicians and their billing staff to review, discuss, and explain the physician payment schedule requirements and billing codes and their appropriate applications. Meetings are at the request of the physicians and their billing staff or may be initiated by the field officer. Ms. Koch provides education to physicians who are Canadian-trained or international medical graduates, who are new to the province or who have been practising in the province for some time. Presentations are also delivered to family medicine residents who are entering their second year of residency. 14 Spring 2011 SMA News Digest Dr. Strydom’s question was resident-related. He found it quite helpful to know that “a service which is insured by the government when provided by a physician is also insured when provided under the supervision of a physician. Payments can be made to the physician for this supervision as long as the physician is available to intervene promptly if necessary. Payment for a supervised service may only be made to the physician providing the supervision.” For more details about this insured service, view page In.17 of the Physician Payment Schedule. With the recent media regarding MS patients seeking treatment in other countries, Ms. Koch mentioned that a hot topic during site visits involves an explanation of patient referrals for out-of-Canada medical coverage. She acknowledged there are situations which arise wherein the Ministry of Health grants prior approval for out-of-Canada medical coverage for Saskatchewan residents in exceptional circumstances. In order for Saskatchewan residents to receive this out-of-Canada medical coverage, their referring specialist must request and receive prior approval from the Ministry of Health prior to seeking the treatment outside of Canada. The specialist’s written request must describe the circumstances of the case, the services requested, and their indication that, to the best of their knowledge, the medical service is not available anywhere in Canada. If the application for out-of-Canada coverage is approved, the Ministry of Health will pay the treatment costs. “When GPs submit these applications, it slows down the process,” explains Ms. Koch. “I recommend coordinating with the appropriate specialist instead of submitting a request that will not be approved.” Further details about this billing topic can be found on page In.6 of the Physician Payment Schedule. To book a meeting or to inquire about the billing review sessions offered by the Medical Services Branch, please contact Charlene Koch at (306) 798-2108 or by email at ckoch@health.gov.sk.ca. For further information and billing details, you can review the Physician Payment Schedule. A link to the payment schedule is available on the SMA website, under the Fees and Negotiations tab.
Medical office property insurance: Know your limits By Doré Collett If your power goes out and your vaccines are compromised, if your office gets broken into, or if your laptop goes on the fritz... are you fully covered? Almost all of the office insurance policies sold by insurers are ‘all risk’ or ‘comprehensive’ package policies. These are the broadest types of policies available in the marketplace. They cover various types of losses due to fire, theft, water and wind damage, and mysterious disappearance. They also provide coverage for general liability, loss of business income, and crime. While these plans may appear to be the same, all of these packages have special limits. Insurers place these limits in policies to avoid exposure to certain types of situations that tend to suffer more frequent losses. The SMA Medical Office Property Program has been designed to better suit medical offices and our members’ needs. The program takes advantage of group buying power to provide superior coverage and more competitive premiums for medical office property and liability insurance – with fewer limits. Compared with the industry standard, the SMA program highlights include: $5 million commercial general liability protection This is covered in the package premium. The industry standard is about $1 million of protection. $25,000 off-premises consequential loss coverage As an example, if you have flu vaccines stored in a fridge, this coverage would provide protection in the event that there is a power cut at a public utility plant that results in a change in temperature, thus spoiling your vaccines. It is not standard practice to cover any amount in this case. $5 million for tenant legal liability Landlords require their tenants to carry this insurance as protection if the tenant is found legally liable for property damage to the building. This high liability limit is included in the package premium. The industry standard is about $1 million of protection. $50,000 coverage for valuable papers This insurance covers the cost of recom- WEALTH piling or retyping your medical files if they are stolen or damaged. The industry standard is $10,000 coverage. $5 million for non-owned auto liability If an employee needs to use his or her own vehicle for business-related tasks, he or she would be covered. This coverage provides a high liability limit to protect your business should your employee be found liable for causing bodily injury or property damage to a third party. Standard practice is that this would not automatically be covered. “When comparing packages, an office insurance policy containing generous special limits provides the best value for your insurance dollars and can have a significant impact on the size of the payout following a loss,” explains Ed Hobday, SMA administrative director. “We were so impressed with the reasonable premiums offered in this package that we decided the SMA office should have the same coverage.” With premiums starting as low as $500 per year, this program combines all of the most necessary coverage into one package for your medical office. Discounts are available for offices equipped with burglar alarm systems or sprinkler systems. Commercial building coverage is also available. The SMA Medical Office Property Insurance Program is available through Mardon Group Insurance. For more information, visit the Mardon Group Insurance website at www.mgins.ca (user ID: SMA, Password: Insurance) or call 1-866-846-4467. To learn more about the various tailored insurance products available to SMA members, contact Cindy Anderson, Senior Insurance Administrator at (306) 244-2196. SMA News Digest Spring 2011 15
Page 1 and 2: SMA CEO OTTAWA-BOUND | Q&A: RURAL L
Page 3 and 4: Ice and snow melt on the South Sask
Page 5 and 6: We have a professional responsibili
Page 7 and 8: tual respect amongst colleagues eve
Page 9 and 10: tioners/family physicians and other
Page 11 and 12: Dr. Carla Holinaty and Dr. Rose Gra
Page 13 and 14: The Physician Health and Well-being
Page 15: Better patient-centered care for lo
Page 19 and 20: 2011 schedule set for the SMA’s i
Page 21 and 22: SMA introduces session for physicia
Page 23 and 24: The 6 th Annual Doctors’ Night Ou
Page 25 and 26: classifieds ANNOUNCEMENTS SMA contr
Page 27 and 28: The Saskatoon Community Clinic is r
Page 29: LOCUM OPPORTUNITIES Locum Opportuni
Page 32: Return undeliverable Canadian addre

Examining collegiality in Saskatchewan - Saskatchewan Medical ...

Create successful ePaper yourself

Delete template?

Save as template?