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"Billing needs to be considered at the beginning of a project so the right paperwork can be filled out in a timely manner." -- Serina Jorgensen - July 14, 2022 And also whenever a POS gets an MSP Payee ID or starts billing, or a clinician is added, or gets an MSP #, or becomes a member of another POS, or starts billing at a POS... |
What is Billing?
Billing is creating, submitting and reconciling claims.
Claims are usually for a service provided by a clinician to a client and are often based on an encounter.
In EMR, most claims are to MSP, but they can also be to WCB (WorkSafeBC), ICBC, RCMP, legal firms or others. These organizations are referred to as the “Payer” because they pay claims.
The POS or provider submitting the claim is referred to as the “Payee”, because they (usually) get paid.
All claims are submitted through Teleplan (also referred to as MSP Teleplan), the BC Ministry of Health MSP telecommunications system.
Billing Setup/Configuration
Billing setup and configuration is:
- Setting up clinics
- Deactivating clinics
- Setting up clinicians
- Deactivating clinicians
- Updating MSP service codes and rates
Stakeholders
| Organization | Contact |
| BC Ministry of Health (MoH) | 604 660-2421 |
| MSP Teleplan | 604-456-6950 (or 1-866-456-6950 outside Vancouver) |
| Physician Compensation Branch | 250-952-3486 |
| VCH Finance | 604-736-2033 |
| PHC Finance | 604-806-9090 |
| PHSA Finance | 604-297-8512 |
POS's & Clinicians
There are different kinds of POS's:
- POS's with their own Payee ID which is used by MD's while NP's use their own MSP #
- POS's without their own Payee ID so all clinicians use their own MSP #
- POS's with physicians on PCN (Primary Care Network) contracts
- POS's that do not bill
- POS's under PHC (Providence Health Care) which has its own Teleplan Data Centre #
- POS's that are PHSA specialty clinics and do not belong to VCH
There are different kinds of clinicians, such as MD's, NP's, RN's, LPN's, ...
- MD's, NP's, RN's, RPN's, or LPN's can do billing (not allied health)
- Some clinicians are on PCN (Primary Care Network) contracts and may use a Payee ID that is not the POS Payee ID or their own MSP #.
- Some clinicians, especially NP's, do shadow billing, where claims are submitted for $0 (no money is paid - it is done for MoH administrative and reporting purposes)
The different kinds of POS's and clinicians have many billing implications.
Identifiers
These are the most important identifiers in Profile EMR billing.
MSP Teleplan Data Centre #
The MSP Teleplan Data Centre # indicates the organization submitting the claims. In VCH Profile EMR we use the the "VCH Community" MSP Teleplan Data Centre #, which is T7326.
MSP #
This is provided by MSP and is the identifier of a clinician, usually an MD or NP, but it could also be an RN (with certified practice). Any clinician billing in EMR must have an MSP #.
A clinician will only ever have one MSP #.
Payee ID
This is provided by MSP and is the identifier of a clinic or clinician that is paid, and it is often linked to a bank account.
A clinic or clinician could have multiple Payee ID's, especially if they bill through different systems which use different Teleplan Data Centre #'s.
MSP # versus Payee ID
When you begin billing in BC you are provided with an MSP # (also referred to as an MSP Practitioner # or MSP Billing #). This number stays with you forever and does not change. This is the number that colleagues will use as your referring practitioner number.
Underneath your MSP # you can have several Payee ID's. A Payee ID simply tells MSP where to send payment for claims submitted under that number.
You begin to add new Payee ID's as you incorporate or begin billing in multiple locations at once. A single Payee ID can only be used to bill through one Teleplan Data Centre #.
https://www.dr-bill.ca/knowledgebase?category=MSP
Settings
Is Financial
The "Is Financial" checkbox MUST be checked for a clinician to do billing in EMR.
Create Claims
This setting has three options:
- "On Appointment"
- "On Attendance"
- "Never"
Claims can be automatically created whenever an appointment is booked ("On Appointment"), or when ever a client is marked Arrived for an appointment ("On Attendance"), or never. This can be set separately for each POS the clinician works at.
"On Appointment" is rarely used, but "On Attendance" is often used, especially for NP's.
This "Member Of" screen also shows where a clinician's MSP # and the POS's (or clinician's) Payee ID is entered for each POS they work at.