Claim Manager is so simple, you can do your billing yourself.

Distribution of Physians by MSP Revenue

Almost third of MSP-enrolled physicians received less than $100,000 in payments in the year 2013/2014. Is it enough to have a billing administrator on payroll?

Less than $99,999
27.8%
$100,000 to $199,999
24.02%
$200,000 to $299,999
20.40%
$300,000 to $399,999
11.73%
$400,000 to $599,999
9.47%
$600,000 and greater
6.59%

BC, 2013/2014

SO SIMPLE

You can do your billing yourself.

Try it today. Limited time offer.

14-DAY FREE TRIAL!

Select custom user interface for your medical occupation.

One size does not fit all. We simplified your billing decisions by creating a custom user-interface for many occupations. Some profiles include:

  • MSP billing software for general practitioners
  • MSP billing software for specialists
  • MSP billing software for “A GP for Me”
  • MSP billing software for ophthalmologists
  • MSP billing software for dermatologists
  • MSP billing software for surgeons
  • MSP billing software for surgical assistants
  • MSP billing software for surgical anesthesiologists

Do not overthink the billing codes.

Seventy percent of all billing items for specialists  are for consultation and returns.

MSP billing for medical specialists
0%
Consultation and returns

Seventy nine per cent of all billing items for general practitioners are for regional examinations.

MSP billing for GP
0%
Regional examinations

Ninety two per cent of all billing items for surgical staff are for anesthesia and surgery.

Surgeons and surgical assistants
0%
ANESTHESIA AND SURGERY

Keep all billing in one place.

Do all your billing in one software. That will make your revenue reporting a breeze.

MSP Benefits

Bill MSP for insured benefits per the MSP payment schedule.

Out-of-pocket Invoices

Bill patients for services not covered by MSP per your private fee schedule.

User Fees

Bill patients for the difference with MSP fees if opt out.

Learn more about why Claim Manager is the simplest MSP billing software for physicians.

Educate yourself about MSP billing for physicians.

What medical services are MSP benefits?

Medical Services Plan (MSP) provides the following benefits
  • medically-required services of a physician, or of a specialist (such as a surgeon, anesthetist or psychiatrist) when referred by a physician;
  • maternity care by a physician or by a midwife;
  • diagnostic services, including x-rays and laboratory services, provided at approved diagnostic facilities, when ordered by a registered physician, midwife, podiatrist, dental surgeon or oral surgeon;
  • dental and oral surgery, when medically required to be performed in hospital (excluding restorative services, i.e.: fillings, caps, crowns, root canals, etc.)*;
  • orthodontic services related to severe congenital facial abnormalities;
  • medically required eye examinations provided by an ophthalmologist or optometrist; and
  • surgical podiatry.
* The removal of healthy wisdom teeth, even if impacted, is not a benefit. Surgical removal of an impacted third molar (wisdom tooth) is an MSP insured service only when hospitalization is medically required, due to the extreme complexity of the extraction and where there is associated pathology.
MSP does not provide coverage for the following:
  • routine physical examinations performed for reasons other than medical necessity;
  • medical examinations, certificates or tests required for life insurance, a driver’s licence, school, immigration, employment, etc.;
  • cosmetic surgery for the alteration of appearance;
  • restorative or other dental work performed in a dental office;
  • eyeglasses, hearing aids, and other equipment or appliances;
  • the services of counsellors or psychologists;
  • routine eye examinations for beneficiaries between the ages of 19 and 64; and
  • chiropractic, physiotherapy, naturopathy, massage therapy, acupuncture, and non-surgical podiatry services for persons not receiving MSP premium assistance.
Medical and healthcare practitioners shall not bill MSP for those services. They should bill their patients directly.
Surgical podiatry services are a benefit for all MSP beneficiaries. However, surgical podiatrists are allowed to opted out of MSP Fee Schedule and charge their patients more. Patients receiving surgical podiatry services may be responsible for
  • operating room or surgical suite fees
  • surgical supplies and
  • service charges over and above what is insured by MSP.
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.

Find your MSP fee schedule

Each medical occupation bills MSP using the applicable MSC Payment Schedule fee items. The MSC fees are established through consultation between Medical Services Commission and the respective professional association. Billing MSP for services that are not on the MSP Fee Schedule or billing MSP for higher amounts is not permitted.   MSC Payment Schedule Amendments to the MSC Payment Schedule
Claim Manager offers built-in, searchable, automatically updated catalogues of MSP Fee Schedules for each medical and healthcare occupation.

What physicians can bill MSP

A healthcare practitioner is eligible to bill MSP if the practitioner Enrolled physicians receive an MSP practitioner number (also known as MSP payment or MSP billing number), which is indicated in MSP claims in a field “treating practitioner”. MSP enrollment status and the possession of an active MSP billing number are contingent upon the practitioner’s continued licensure by the  College of Physicians and Surgeons of British Columbia (CPSBC). Any change in licensure, such as the renewal of a temporary license or specialty, must be reported to MSP to avoid refusal of claims.
Each physician 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 a practitioner requests an additional MSP payment number. If physicians want to make their clinic an MSP payee, a clinic can receive an MSP payment number, too.
In case of a change in address, telephone number, specialty or licence status, physicians should advise MSP. MSP requires accurate information to provide physicians with billing support and ensure their claims’ validity.

What patients are MSP beneficiaries?

MSP Enrollment for the Patients
Under the Medical Protection Act, eligible residents of B.C. must enroll themselves and their dependents with Medical Services Plan (MSP). If your patients have questions about MSP enrollment eligibility, please refer them to the MSP eligibility and enrollment web page.
 BC Services Card
MSP enrollment is confirmed by issuing an applicant the BC Services Card (former BC CareCard). Being presented with the healthcare card is not enough to verify patient’s MSP enrollment because the patient may carry a prematurely expired MSP card. To verify the patient’s MSP eligibility on the date of service, practitioners need to make an eligibility inquiry to MSP.
There are four ways to check MSP status of the patients.
  1. Request an instant MSP eligibility report in Claim Manager.
  2. Call the automated Practitioner Information Line:
    • Victoria: (250) 952-3102 or (250) 383-1226
    • Vancouver: (604) 669-6667
    • Toll-free: 1 800 742-6165
  3. Use MSP Web Access.
  4. Fax a request on a coverage research form if the PHN is unknown:
    • fax: (250) 952-3101.
Notes:
  1. The services are listed in an order of convenience.
  2. The patient’s personal health number (PHN) must be provided for steps 1, 2 and 3.
  3. MSP Teleplan registration is required for steps 1 and 3.
  4. Practitioner Information Line is an automated service that handles coverage inquiries using an interactive voice response (IVR) system.
Providers of required medical services can request an instant MSP eligibility report in Claim Manager. They must bill MSP if the MSP eligibility report reads that the patient
  • “Is Eligible for Medical Coverage Under MSP” on the date of service.

Find the right ICD-9 diagnostic code

Do you qualify for rural retention program bonus?

Select the right location code for your claims

Use one of the following codes to indicate the where the services took place. (A) Practitioner’s Office – In Community (C) Residential Care/Assisted Living Residence (D) Diagnostic Facility (E) Hospital – Emergency Room (Unscheduled Patient) (F) Private Medical / Surgical Facility (G) Hospital – Day Care (Surgery) (H) Hospital (I) Hospital – Inpatient (M) Mental Health Centre (O) Physicians Office (P) Hospital – Outpatient (R) Patient’s Private Home (S) PHC Community Location (T) Practitioner’s Office – In Publicly Administered Facility (Z) Other (e.g., accident site, in an ambulance, etc.)

SO SIMPLE

You can do your billing yourself.

Try it today. Limited time offer.

14 DAY FREE TRIAL!

MSP Billing Statistics For Physicians.

GP account for the largest number of MSP payees.

GPs, share
0%
GPs, number
0
BC, 2013/2014
GPs, revenues
$0M+

Other medical occupations by number of payees

Excluding general practice and laboratory medicine

Psychiatry
771
Anaesthesia
487
Radiology
309
Internal Medicine
293
Paediatrics
261
Obstetrics & Gynaecology
257
Other 30 specialties
2451

BC, 2013/2014

The four top specialies by MSP patient count

GP
0K
Radiology
0K
Microbiology
0K
Opthalmology
0K

BC, 2013/2014