Want to simplify your MSP billing? Join Claim Manager.

MSP Billing for MD

MSP billing for medical doctors is not that complex if your billing software is customized for your practice.

MSP Billing for Midwives

Claim Manager is the only MSP billing software with unique custom user interface for B.C. midwives.

MSP Billing for Optometrists

Claim Manager is the only software for optometrists that integrates MSP billing with eClaims.

MSP Billing for Allied Health Professionals

Are you a B.C. chiropractor, acupuncturist, physiotherapist or massage therapist? You’ll love Claim Manager.

SO SIMPLE

You can do your billing yourself.

Try it today. Limited time offer.

14-DAY FREE TRIAL!

Ten Reasons to Do MSP Billing with Claim Manager

Whether you are a solo medical practitioner or a clinic owner, Claim Manager makes your MSP billing simple.

Complete your claims quickly.

Have your claims pre-loaded to save your time.

Auto-fill patient profile

Auto-fill new patients’ profiles with MSP Teleplan integration lookup.

Auto-fill MSP billing codes

Auto-fill ICD-9 codes and referral information for return patients.

Auto-fill MSP location codes

Auto-fill rural program and location codes to qualify for MSP premiums.

Get paid faster.

Validate your claims before submission to avoid declined claims.

Validate BC Services Card

Validate your patient’s BC Services Card number to avoid typing mistakes.

Validate MSP Patient Profile

Validate MSP patient’s date of birth, name and gender to avoid errors.

Validate MSP Coverage

Confirm that the patient has MSP coverage for your services.

Check MSP coverage.

Bill patients with invalid MSP coverage directly, while they are still in your office.

MSP Coverage in Every Claim

Never forget to check MSP coverage because it is built-in into every claim.

Instant MSP Coverage

Get an instant MSP coverage report without long waiting time on a phone.

MSP coverage for past visits

Check MSP coverage for the last 6 months if billing MSP for past visits.

Don’t overthink the diagnostic code.

Three easy ways to select an ICD-9 code for your claim.

Recommended ICD-9 Codes

Find the right ICD-9 code in the custom catalog for your health profession.

Searchable ICD-9 Codes

Find an odd diagnostic code using the complete searchable ICD-9 catalog.

Favorite ICD-9 Codes

Quickly select an ICD-9 code from the list of your popular diagnostic codes.

Find the right MSP billing code.

Not sure about the MSP billing code or fee amount? Claim Manager has it covered.

Browse Recommended Codes

Select a code from the catalog of MSP billing codes for your profession. Fast.

Search for Rare MSP Codes

Quickly search MSP catalog for an odd billing code by its brief description.

Use Personal MSP Catalog

Easily select a code from the personal list generated by your billing choices.

Pre-loaded Billing Codes

Save time with pre-loaded MSP billing codes for allied health professionals.

Auto-updated Fee Schedule

Keep your MSP billing fees current with the automatic schedule updates.

Accessible Historical Values

Access historical values of MSP fee amounts when billing for past days.

Do complicated MSP billing with ease.

Easily handle complicated medical billing cases, like expired, reciprocal or erroneous MSP claims.

Bill over-age MSP claims

Got an approval for over-age claim? Submit it with the special billing code.

Bill Reciprocal MSP Claims

Have occasional out-of-province patients? Bill MSP for them.

Reverse Erroneous Claims

Reverse erroneous health claims and payments with electronic debit request.

Stay on top of your MSP billing.

Never miss an important MSP billing event.

Declined MSP Claim Alert

Get email alerts and resubmit declined claims in the same billing period.

MSP Remittance Alert

Anticipate the incoming payment with the remittance report alert.

MSP Close-Off Day Alert

Be reminded about the approaching close-off day to complete your billing.

Do MSP billing for any MSP billing option.

You can enroll in any MSP billing option and still use Claim Manager.

Opt In MSP billing

Do MSP billing for MSP Opt In medical practitioners – doctors and midwives.

Soft Opt Out MSP Billing

Do MSP billing for Soft Opt Out health professionals – most of the allied.

Hard Opt Out MSP Billing

Do MSP billing for MSP Hard Opt Out health practitioners – some allied.

Bill many facets of solo practice with one account.

Solo health professionals might wear many hats, but they need only one Claim Manager account.

Bill for Multiple Locations

Working part-time in many places? Bill for all places with one account.

Bill for Several Occupations

Licensed by several colleges? Bill for multiple occupations with one account.

Bill for Mixed Services

Working in hospital and community? Bill for both places with one account.

Do MSP billing for the whole clinic with one account.

Accommodate any MSP enrollment options of your employees under one flexible clinic account.

Assignment of Payments

Have part-time employees? Bill for the staff on assignment of payment.

Mixed Health Professionals

Employ varied health occupations? Bill for all providers with one clinic account.

Mixed MSP Billing Options

Opt In and Out? Bill for all MSP billing options with one clinic account.

SO SIMPLE

You can do your billing yourself.

Try it today. Limited time offer.

14-DAY FREE TRIAL!

Educate Yourself About MSP Billing

Doing MSP billing yourself is not that hard if you understand how it works. We prepared a simple MSP billing guide for you.

What is MSP?

Medical Services Plan of British Columbia (MSP) is a health insurance plan run by the government of British Columbia. MSP pays for most of the health needs of eligible British Columbia residents.
Since April 2005, MSP billing has been administered by MAXIMUS BC, a U.S.-based company, under a 10-year contract. The government of B.C. has extended the Master Service Agreement with MAXIMUS BC by five years to continue to deliver Health Insurance BC services until March 31, 2020. MAXIMUS BC also administers PharmaCare, another important health care program in British Columbia. The Medical Services Plan (MSP) and PharmaCare Operations are collectively called Health Insurance BC (HIBC).
MSP Teleplan is a computerized system set up by the Ministry of Health of B.C. to automate claim processing and payments for eligible medical and healthcare practitioners in B.C. MSP Teleplan receives and processes over 5 million claims monthly, valued at approximately $116 million. MSP Teleplan is a black box that does not have a user interface for practitioners. It requires integration with patient management and billing systems, such as Claim Manager, that allow practitioners to create and submit claims and to reconcile MSP payments. MSP Teleplan is not the only way to submit MSP claims, but it is a preferred way because it offers functionality that is not available by other means. This functionality includes two-way real-time communication between a practitioner and the Medical Services Plan, broadcast and private messages from MSP, electronic payment reports (remittance reports), 24-hour error notification reports and MSP eligibility reports.
Claim Manager provides a user interface for connecting to and exchanging information with MSP Teleplan. It integrates MSP billing into clinics’ patient management systems. Claim Manager is developed by TripleTee Software,  a registered MSP Teleplan vendor since 2005. Claim Manager was tested by TripleTee Software and MSP Teleplan quality assurance specialists before being approved for MSP billing.

Find your MSP fee schedule.

A medical or healthcare practitioner can bill MSP for the services listed in the MSP Fee Schedule for his or her occupation. The MSP eligible services and fees are established through consultation between the Medical Services Commission and professional associations. Billing MSP for services that are not on the MSP Fee Schedule or billing MSP for higher amounts is not permitted. MSP Payment Schedule for physicians Eye Examination Benefits MSP Payment schedule for optometrists MSP Payment schedule for non-surgical podiatrists MSP Payment schedule for acupuncturists MSP Payment schedule for massage therapists MSP Payment schedule for chiropractors MSP Payment schedule for naturopaths MSP Payment schedule for physiotherapists MSP Payment schedule for midwives
Supplementary benefit practitioners, optometrists and surgical podiatrists can opt out of the Fee Schedule and charge their patients more. Opted-out practitioners must advise their patients prior to the treatment being performed
  • that they have opted out;
  • how much is reimbursed by MSP; and
  • how much the patient will be paying in addition to the MSP fee.
Opted Out practitioners should charge the fee difference directly to the patients or to their group insurance plans, if applicable. They cannot bill MSP for amounts that differ from the MSP Fee Schedule. Supplementary benefits practitioners include acupuncturists, chiropractors, physiotherapists, massage therapists, naturopathic doctors and non-surgical podiatrists.
Claim Manager offers built-in, searchable, automatically updated catalogues of MSP Fee Schedules for each medical and healthcare occupation. If an opted out practitioner charges more than stipulated by MSP, the balance is calculated and billed to the group insurance plan and/or the patient.

What services are excluded from MSP benefits?

Except for referred “diagnostic facility” services, a medical record is not considered adequate unless it contains all information which may be designated or implied in the MSC Payment Schedule for the service. Any other medical practitioner of the same specialty, who is unfamiliar with both the patient and the attending medical practitioner, should be able to readily determine the following from a record at hand: a. Date and location of the service. b. Identification of the patient and the attending medical practitioner. c. Presenting complaint(s) and presenting symptoms and signs, including their history. d. All pertinent previous history including pertinent family history. e. The relevant results, both negative and positive, of a systematic enquiry pertinent to the patient’s problem(s). f. Identification of the extent of the physical examination including pertinent positive and negative findings. g. Results of any investigations carried out during the encounter. h. Summation of the problem and plan of management. For referred “diagnostic facility” services, an adequate medical record must include: a. Date and location of patient encounter or specimen obtained. b. Identification of the patient and the referring practitioner. c. Problem and/or diagnosis giving rise to the referral where appropriate. d. Identification of the specific services requested by the referring practitioner. e. Identification of specific services performed but not specifically requested by the referring practitioner, and identification of the medical practitioner who authorized the additional services. f. Original requisition or a copy or electronic reproduction of the requisition, in which the method for copying or producing an electronic reproduction must be approved by the Commission, the nature of the copy or electronic reproduction must comply with the intent relative to the form and content of the standard laboratory requisition, and must be auditable to the original source document. g. Where a requisition is submitted electronically, the electronic ordering methods must be approved by the Commission employing guidelines established jointly by MSP and BCMA. h. Where a written requisition was never submitted by the referring practitioner, the laboratory staff person who recorded the verbal requisition must be identified. The requisitions must be retained for 3 years. i. Results of all services rendered, and interpretation where appropriate. These data must be retained for 3 years.
1. Services are not benefits of MSP if a medical practitioner provides them to the following members of the medical practitioner’s family: a) a spouse, b) a son or daughter, c) a step-son or step-daughter, d) a parent or step-parent, e) a parent of a spouse, f) a grandparent, g) a grandchild, h) a brother or sister, or i) a spouse of a person referred to in paragraph (b) to (h). 2. Services are not benefits of MSP if a medical practitioner provides them to a member of the same household as the medical practitioner.
Fee for Service claims for any physician service(s) that is funded under a service contract, or compensated for under a sessional or salaried payment arrangement, must not be billed to MSP. When physicians who receive compensation under a service contract, sessional payment or salaried arrangement are billing for an unrelated service, the appropriate location code and facility code should be included on all Fee for Service claims.

What health professionals can bill MSP?

Only practitioners who enroll with MSP qualify for MSP billing. Enrolled practitioners are granted an MSP practitioner number (also known as MSP payment or MSP billing number) that has to be indicated in MSP claims in the field “treating practitioner”.
A practitioner is eligible to enroll with MSP if the practitioner is licensed by a professional College/Association. MSP enrollment status, and therefore the possession of an active MSP billing number, is contingent upon the practitioner’s continued licensure by the appropriate licensing body. Any change in licensure, such as the renewal of a temporary license or specialty, must be reported to MSP to avoid refusal of claims. MSP enrolls
  • physicians
  • specialists (surgeons, anaesthetists, psychiatrists, etc.)
  • dentists
  • optometrists
  • ophthalmologists
  • physiotherapists
  • chiropractors
  • naturopathic doctors
  • registered massage therapists
  • acupuncturists
  • podiatrists
  • midwives.
Each practitioner enrolled with MSP is assigned a billing number consisting of two numbers:
  • a practitioner number, which identifies the practitioner rendering the service, and
  • a payment number, which identifies the person to whom payment is to be made.
MSP practitioner and payment numbers are usually the same, unless the practitioner requests an additional MSP payment number. A practitioner with multiple specialties receives a unique MSP practitioner number for each specialty. If practitioners want to make their clinic an MSP payee, the clinic can receive an MSP payment number, too.
If a practitioner changes address or telephone number, or if there is a change in specialty or licence status, the practitioner must advise MSP so that the practitioner’s records can be updated accordingly. Timely notification of changes enables MSP to provide practitioners with accurate and efficient service and helps prevent unnecessary refusal of claims.
Optometrists, chiropractors, physiotherapists, naturopaths, registered massage therapists, acupuncturists, non-surgical podiatrists, midwives, and some groups of physicians and specialists can conveniently use Claim Manager to bill MSP. Non-enrolled practitioners can use Claim Manager to bill other insurers and patients.

The MSP billing cycle

MSP processes claims in cycles, with semi-monthly payments. Most claims are paid after the first submission.

Complete Billing Cycle

Most MSP claims are paid in one billing cycle, which consists of three steps: check patient’s eligibility for MSP benefit, submit claim and receive payment report.

Resubmit Declined Claims

Due to human error, about one percent of MSP claims get declined. An explanation is provided. Most declined claims can be corrected and resubmitted.

Important stages of MSP claim processing

Each MSP billing cycle has three deadlines:
  1. The close-off day
  2. The remittance day
  3. The payment day.
The close off day is when MSP starts processing all submitted claims. Any claims submitted after the close off will not be processed until the next billing cycle. The close off day happens once or twice a month, depending on the practitioner’s billing option. The remittance day is when MSP sends out payment reports (remittance reports) for processed claims. The report notifies practitioners about the expected amount of MSP payment. It shows a payment decision on each claim. The remittance day happens about a week after the close off. The payment day  is when MSP sends out cheques or makes direct bank transfers. The payment day happens about two days after the remittance day. The deadlines are scheduled in an annual MSP Payment Schedule.
MSP Teleplan processes claims in two steps:
  1. Pre-Edit
  2. Adjudication.
Pre-Edit claim processing is done automatically by a programmed job that runs almost nightly. The purpose of this job is to speed up practitioners’ cash flow. It chews on their claims to find errors that might make the claims inadmissible on the close-off date. Some verification examples include:
  • Is the practitioner’s MSP payment number approved for the indicated Teleplan Data Centre?
  • Is the practitioner authorized to bill for the service?
  • Does the claim contain valid billing codes (PHN, ICD-9, fee items, etc.)?
  • Does the claim have an empty mandatory field?
  • Does the personal health number (PHN) match the patient’s name?
  • Does the fee item match the fee amount?
If a claim does not pass the Pre-Edit stage, it is returned to the practitioner to be corrected and submitted again. Unless rejection is final, a claim can be resubmitted multiple times. Submit your claims as soon as possible to allow enough time to pass the Pre-Edit stage before the close-off. The Pre-Edit job results in the Detailed Remittance report. The Detailed Remittance report contains information about declined claims that did not make it to the Adjudication stage. The Adjudication stage happens after the close-off and only applies to claims that passed the Pre-Edit. This programmed job uses about 5,000 automated rules to adjudicate a payment. For example, it might cross-examine the claims submitted by multiple practitioners for the patient. It also might update the billed amounts to match the most recent changes in the MSP Fee Schedule. The Adjudication runs twice monthly. About ninety-seven per cent of claims are adjudicated automatically. Only three per cent are processed manually. Manual claims are often held in process for longer than one billing cycle. The Adjudication job results the Remittance Report. The Remittance report advises practitioners about the amount of the upcoming payment. The Remittance report can contain information about paid and declined claims. Many claims declined at this stage can still be corrected and resubmitted, but they will not be processed until the next close-off date.
The outcomes of all stages of the MSP billing cycle are communicated to practitioners in encrypted electronic files. Practitioners need to use MSP Teleplan vendor’s software, like Claim Manager, to decipher and read the reports. Claim Manager does more than that. It implements internal validation rules to forestall declined claims whenever possible. If claims are still declined, it alerts practitioners, providing an easy method for correction. All final rejections can be re-billed directly to the patient or to another insurer. When Claim Manager receives a remittance report, it reconciles accounts receivable, matching payments with claims. Claim Manager wraps up the billing cycle with a myriad of custom reports that can be used for analysis or income tax calculation.

MSP payments are not instant.

According to MSP, approximately 95% of all claims are processed within 30 days, with the majority being paid within 14 days. Processing times depend on the timing of the submissions and the complexity of the claims.
Payments might be delayed if claims contain incomplete or inaccurate information or if they require manual adjustment. Usually such claims are shown in remittance files with the note “held for future processing.”
Remittance statements issued by MSP should be reviewed carefully to reconcile all claims and payments. Adjusted claims will show explanatory codes for any adjustments. If the practitioner disagrees with an adjustment, the claim and explanation can be resubmitted to MSP for reassessment. Further disagreements should be referred to the BCMA Reference Committee for review and subsequent recommendation to the Commission. – MSC Payment Schedule, C.12.

Do your MSP billing via MSP Teleplan.

Billing MSP through Teleplan requires that MSP payees store their billing information in a database, real or virtual. Such a database is called a Teleplan Data Centre. Data centers send MSP claims to Teleplan, and Teleplan returns remittance reports. Practitioners who want to share access to their billing database with other practitioners in the clinic need to belong to the same Teleplan data center. Each Data Center receives a unique number from MSP Teleplan, a Data Centre Number. A data centre number  starts with a letter “T” followed by four digits, for example T1234.
An MSP payee is connected to a Data Centre through the MSP payment number. Each MSP payment number can belong to only one Teleplan Data Centre at a time. An MSP payee needs to open an additional MSP payment number to join an additional Teleplan Data Centre. An MSP payee includes a practitioner, a clinic or a hospital.
All MSP payees that belong to the same Teleplan Data Centre must use the same MSP billing software. They can change the software at any time without changing the Teleplan Data Centre. If a single practitioner of a group data centre wants to change the software, he or she needs to open a new Teleplan Data Centre.
A practitioner who works in multiple locations can do his or her billing through a single MSP Teleplan Data Centre. He or she does not need to join the data centres of the clinics.
Not everyone needs to join a Teleplan data centre to bill MSP Teleplan electronically. An alternative way is to make an assignment of MSP payments to a clinic or a practitioner who already belongs to a data centre. The main difference between joining a data centre and using an assignment of payments is that the former allows the practitioner to remain a payee of MSP funds and the latter transfers the payments to the assignee. An assignment of payment is most popular in a clinical setting, where a data center is opened for the clinic’s payment number and all the practitioners assign their MSP payments to the clinic. The clinic’s owner makes payments to the practitioners after collecting all the clinic’s revenues. An Assignment of MSP Payment is a legal agreement through which a practitioner designates a different payee for all of his or her claims submitted with that payee number. The payment number might belong to another practitioner or a group, such as a clinic or hospital. MSP billing is usually handled by the owner of the payment number through its own Teleplan Data Centre. There are several types of payment assignments. The most popular are Locum Tenens – When a practitioner replaces another during holidays or sickness, he or she can assign MSP payments to the principal practitioner. The assignment must be limited to the specific period of coverage. Clinic or Associated Group – Practitioners may assign payment to a clinic or group practice. The term of the assignment may be for any period up to, but not exceeding, five years. If the term is to be extended, new assignment forms must be completed and submitted prior to the expiry of the current term. An assignment of payment does not preclude the practitioner from joining another data centre using his or her own practitioner number, from opening additional payment numbers or from making multiple assignments of payments to multiple places of employment.
Users of Claim Manager do MSP billing via their own Teleplan Data Centres. A receptionist in a clinic can do billing for all practitioners under one account because all users of a Teleplan Data Centre share one billing database. Claim Manager supports all Teleplan registration options, including assignment of payments and practitioners with multiple specialties and various billing options, such as opt in, soft opt out and hard opt out.

Stay away from MSP online claim forms.

The best way to bill MSP is by MSP Teleplan. However, there is another option – billling MSP using online MSP Claim Forms. Your can find them here: Pay Practitioner form Pay Patient form The forms are free of charge but utterly inconvenient. We do not recommend to use the forms.
You might ask yourself – why would I want to pay for Claim Manager if there are free MSP claim forms? Here is why. The forms are just that – blank forms. They are not your claims’ management system. Every time you need to submit a claim, you enter a tremendous amount of repetitive data: patient’s PHN, name, date of birth, date of service, fee item code, fee amount, diagnostic code, your billing number, your payment number, your name – there is no end to it! It is like filling in a long questionnaire on a blank piece of paper. There are no built-in catalogs of diagnostic or fee item codes, so you need to look them up in the books. No information that you enter in the form is saved for future reference. The forms do not remember your patients or their diagnosis. They don’t remember which dates you billed. Every time, you start from a blank screen. Furthermore, there is always room for errors that will delay or eliminate your payments. What if you misspelled a name? How do you remember which dates you billed and which you did not? Which claims need to be rebilled and why? How would you know if you missed a claim? There is no system in place that tracks the status of your claims or the history of your billing. Then there is the matter of payment reconciliation. You will receive your remittance report on paper by regular mail, so you will have to reconcile your claims manually. Find a claim in your records. Find it in your payment report. Put a check mark. Repeat. Do you want to do that? Or do you want Claim Manager to do everything for you, including patient eligibility checks, group insurance billing, direct patient billing and income reports? Leave billing to computers. Spend your life on what you love. That is why healthcare practitioners sign up for patient management and billing programs like Claim Manager.

MSP is a billing agent of ICBC and WorkSafeBC.

In some cases MSP acts as a claim processing agent for ICBC (the Insurance Corporation of B.C.) and WorkSafeBC (Workers Compensation Board, former WCB). This partnership streamlines the billing process for registered practitioners as they only have to submit claims to one agency. Practitioners who can bill ICBC and WorkSafeBC by MSP Teleplan.
  • Specialty
  • ICBC
  • WorkSafeBC
  • RMTs
  • on paper
  • by MSP Teleplan
  • Physio
  • by MSP Teleplan
  • by MSP Teleplan
  • Chiro: fee-for-service
  • by MSP Teleplan
  • by MSP Teleplan
  • Chiro: flat fee
  • by fax
  • by MSP Teleplan
  • Acupuncturists
  • N/A
  • on paper
  • Optometrists
  • N/A
  • on paper
  • Podiatrists
  • N/A
  • on paper

SO SIMPLE

You can do your billing yourself.

Try it today. Limited time offer.

14-DAY FREE TRIAL!

Learn More About MSP Billing for Your Health Profession

There is more to MSP billing when it comes down to your health occupation. Click on your specialty to learn more.