Intro to Family Medicine Billing in Ontario Part 1 (2024 Update)

[@BreakingBadDebt]

𝗧𝗼𝗽𝗶𝗰𝘀 𝗖𝗼𝘃𝗲𝗿𝗲𝗱: 0:00 - Intro 1:37 - Resident Survey: Comfort with asking preceptor about billing 3:46 - What can or can’t you bill OHIP for? 6:20 - Billing Efficiency Tips for Residents 9:58 - 5 Billing Resources to Know 13:05 - Understanding your EMR 15:37 - Most Common Billing Codes 19:36 - Virtual Care Billing 23:18 - Mental Health Codes 23:58 - Screening/ Preventative Care Codes 25:04 - Vaccination Codes 25:45 - Procedure Codes 26:15 - Obstetrics / STI Billing 27:52 - Smoking Cessation billing 29:10 - Billing Case 1 30:11 - Billing Case 2 30:59 - Billing Case 3 31:35 - Billing Case 4 32:08 - Billing Case 5 33:08 - Billing Case 6 33:51 - Billing Case 7 𝗥𝗲𝘀𝗼𝘂𝗿𝗰𝗲𝘀: **Dr Steph's Templates & Other resources: drive.google.com/drive/folders/1yJ9FrszahqTRwYnM-ekKfiKugpMwBA0S?usp=drive_link 1) Part 2 Billing Lecture: kzbin.info/www/bejne/jqfUoGmEeJanlcU 2) FHO Family Medicine Billing Lecture (Pt 1): kzbin.info/www/bejne/hZ7Go5dpfpmFbNU 3) FHO Family Medicine Billing Practice Cases (Pt 2): kzbin.info/www/bejne/o6HNcqFvpqeXfas 4) Income Stabilization & New Grad Entry Program (NGEP) (Pt 3): kzbin.info/www/bejne/mqWThZemgpaqrZY 5) From Resident to Staff Doctor: Job Search, Starting Practice, Getting Paid: kzbin.info/www/bejne/eaanpHiPZ6iShbc 6) How do Doctors Get Paid?: kzbin.info/www/bejne/jmbYgJ54ZaeojZI 7) Career Mistakes to Avoid for New Doctors: kzbin.info/www/bejne/d2WwdIdvi7d4htU 8) Contract Negotiation for Doctors: kzbin.info/www/bejne/iYanYXWmZ5dlpaM

[@kwakuagyemang6668]

You are a lifesaver Dr. Steph!!! THANK YOU!!!!

[@AtifHussain93]

This is excellent. Thank you!

[@jessicaseffelaar-nagy1554]

Is there a billing course within OHIP that they offer? MSB offers a basic course for free in Saskatchewan for physicians, NP's and Medical Billers.

[@BreakingBadDebt]

Unfortunately the MOH in Ontario doesn’t provide a billing course, which is why I made these videos. OMA has some billing modules and seminars on their members portal that you can check out as well!

[@nightmansmemo]

I'm currently on disability and I'm looking into medical billing and coding as a new career as it may work with my disability quite well. I'm looking for more information to make sure this is something that I can do. I did find an online course for ohip that was roughly about $500 what would be your recommendations

[@BreakingBadDebt]

Out of curiosity what's the course? I don't think you need to do a course to learn about how billing works in Ontario, there are a lot of free resources for family medicine billing including the videos I've made, as well as OMA billing webinars that you can access through your OMA members portal.

[@nightmansmemo]

@@BreakingBadDebt it was a course I found looking through Google

[@signotas3625]

Can you combine the K013 (counselling) code with A007, A001 or A003 (general visit codes) codes? For example patient is presenting for chest pain that you think is GERD and you counsel them on non-pharmacological options regarding GERD management? Or for example patient has headaches but you discover they have insomnia and you discuss sleep hygiene.

[@BreakingBadDebt]

I have combined K013 with A007 and A001 before but just make sure you bill different diagnostic code for each. I haven't combined K013 with A003 just because if the pt comes in for chest pain and you counsel them for 20 min on GERD, it's still in relation to the same issue they came in for the first place - so in that situation I would only bill A003. Also from a time management perspective, if you're spending that much time with a patient to need to bill a K013 and A003, it is probably better for time efficiency to bill the A003 then ask pt to come back for another booked appt for the counselling to bill the K013.

[@signotas3625]

Thank you! Appreciate all the time and effort you put into making all this so clear.

[@pardogg]

Dear Dr Steph: What is the appropriate billing code for a meet and greet? What do you think should be required for a meet and greet consultation? Thank you kindly, Par (new family physician in Ontario, previous practice as a GP in Australia)

[@BreakingBadDebt]

Welcome to Ontario! For M&G there are 2 codes I’ve seen being billed: A007 or K131 (or any of the preventative visit billing codes). Usually I will discuss the clinic policies, hours and fill in the CPP. Sometimes if the patient has a fairly extensive history and I end up taking a past med hx, social hx and do a comprehensive physical exam, I will bill a K131/2 + Q200 to roster them.

[@pardogg]

@@BreakingBadDebt, I'm very grateful for your reply. Do you also see the K013 item number used for meet-and-greets? I note these require a diagnostic code, so I wonder how much time must go into specific health education as opposed to clinic policy, my background, and how I practice medicine, so I could justify the billing.

[@BreakingBadDebt]

@@pardogg Hey, I personally don't bill K013 for M&Gs because you're only limited to 3 of these / pt/year so I prefer to save them for when I actually need to counsel the pt on something. As you identified, the K013 is a counselling code for a pre-booked appt where the reason for counselling is identified with the booking (i.e. a prebooked appt to talk about obesity).

[@auslander1026]

would appreciate a clarification - if i see the patient and nurse does vaccination (before or after) can I still bill for vaccine?

[@BreakingBadDebt]

Yes you can bill for the vaccine that your nurse did as it’s considered a delegated act. However if your NP saw a patient and did the vaccine independently on a day when you weren’t there then you can’t bill for it. www.cpso.on.ca/Physicians/Policies-Guidance/Policies/Delegation-of-Controlled-Acts