Changes to medical billing and physician wages go into effect in April 2020 and 2021 but there are also changes to insured services..“To protect the safety of patients, we will limit the amount of patients doctors can see to 65 per day,” Shandro said..The impetus for this change was research out of the U.S. which showed doctors suffer from burnout and that affects patient care. The new rules will not apply to either rural practices or emergency rooms..Shandro said that even with a freeze on expenditures, the government expected billing to increase by $2 billion dollars over three years. Currently, physician wages and benefits cost $5.4 billion annually..The complex modifier billing will be reduced from $18 to $9 at minute 16, and $18 at minute 26 and will come into effect in April. That will be phased out in 2021 with only one complex modifier being allowed at minute 26 of $25. The complex modifier is in addition to the base rate of $41 per patient..Alberta doctors were using the complex modifiers in more than 50 per cent of patients but the Minister said that only 25 per cent of the population has complexities that should require additional billing..“The patient population in Alberta is not that complex,” Shandro said..“The billing model was definitely being used incorrectly.”.Other changes include discontinuing clinical stipends for physicians who are also being paid by AHS, disallowing additional billing for overhead, and eliminating the continuing education reimbursement..There will also be a reduction in insured services. Referrals coming from chiropractors or physiotherapists will no longer be covered by Alberta Health, and driver medical exams for seniors will not longer be covered..Shandro said talks with the Alberta Medical Association broke down last week and since there is no mandate for the province have an agreement with the Alberta Medical Association, the government will end the requirement with an Order in Council, effective Feb. 20..Doctors will still be able to bill for their services and they will still be paid, he said..Deirdre is a Senior Reporter with Western Standard.dmaclean@westernstandardonline.com, @Mitchell_AB on Twitter
Changes to medical billing and physician wages go into effect in April 2020 and 2021 but there are also changes to insured services..“To protect the safety of patients, we will limit the amount of patients doctors can see to 65 per day,” Shandro said..The impetus for this change was research out of the U.S. which showed doctors suffer from burnout and that affects patient care. The new rules will not apply to either rural practices or emergency rooms..Shandro said that even with a freeze on expenditures, the government expected billing to increase by $2 billion dollars over three years. Currently, physician wages and benefits cost $5.4 billion annually..The complex modifier billing will be reduced from $18 to $9 at minute 16, and $18 at minute 26 and will come into effect in April. That will be phased out in 2021 with only one complex modifier being allowed at minute 26 of $25. The complex modifier is in addition to the base rate of $41 per patient..Alberta doctors were using the complex modifiers in more than 50 per cent of patients but the Minister said that only 25 per cent of the population has complexities that should require additional billing..“The patient population in Alberta is not that complex,” Shandro said..“The billing model was definitely being used incorrectly.”.Other changes include discontinuing clinical stipends for physicians who are also being paid by AHS, disallowing additional billing for overhead, and eliminating the continuing education reimbursement..There will also be a reduction in insured services. Referrals coming from chiropractors or physiotherapists will no longer be covered by Alberta Health, and driver medical exams for seniors will not longer be covered..Shandro said talks with the Alberta Medical Association broke down last week and since there is no mandate for the province have an agreement with the Alberta Medical Association, the government will end the requirement with an Order in Council, effective Feb. 20..Doctors will still be able to bill for their services and they will still be paid, he said..Deirdre is a Senior Reporter with Western Standard.dmaclean@westernstandardonline.com, @Mitchell_AB on Twitter
