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Specialist Billing Tips

How to bill using Dr. Bill

Megan Halstead avatar
Written by Megan Halstead
Updated over a week ago

1. Add a Patient

To quickly add a patient, simply snap a photo of each patient label. Dr. Bill will capture all the patient information. You can also add a patient manually. Once created, you can log claims for a patient immediately.

Adding Claims

Simply select New Claim after adding or viewing a patient. Follow the samples below on how to enter your Call Backs or Continuing Care (CCS).

Call Backs (Call Out Fees)

To be eligible for Continuing Care fees, you must first be called INTO the hospital from an outside location. This means you cannot already be at the hospital caring for patients, or scheduled to come in and see patients. When called in, the first patient you see you will bill a Call Out fee. Any patient you see thereafter will qualify for Continuing Care fees (CCS). The fee code depends on the time the call was received. 

01200: Call placed between 1800-2300

01201: Call placed between 2300-0800

01202: Call placed on a weekend or Stat Holiday between 0800-2300

See sample below.

 Note: The default time that appears for the start is the current time. This allows for quick billing at the time of receiving the call back.

Continuing Care Fees (billed to subsequent patients)

After you have billed a Call Out fee on the first patient seen, you are eligible to bill Continuing Care (CCS) on additional patients you see on that same call out. It is important to note that continuing care can only be logged in 30 minute blocks of time. If you see two patients in that 30 minutes, you will log the Continuing Care on the last patient seen in that 30 minutes. 

Non-Operative Continuing Care

01205: Service rendered between 1800-2300

01206: Service rendered between 2300-0800

01207: Service rendered on a weekend or Stat Holiday between 0800-2300

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Advice Fees (Telephone, Video, or Face to Face Communication)

There are several fees that are billable that replace the need to see a patient in person. When your advice is requested by another physician you can bill one of the following...

10000 - Urgent Specialist Advice on patient with previous visit/service within 2 hours

Initiated by a Specialist, Family Physician or Health care Practitioner. Verbal, real-time response within 2 hours of the initiating physician’s or practitioner’s request

Notes:

i) Payable for telephone, video technology or face to face communication only. Not payable for written communication (i.e. fax, letter, email).
ii) Document time of initiating request, time of response as well as advice given and to whom.
iii) Include the practitioner number of the physician or Health Care Practitioner requesting the advice in the [referred by] field when submitting claim.
iv) Not payable in addition to another service on the same day for the same patient by same practitioner.
v) Limited to one claim per patient per physician per day.

10001: Urgent Specialist advice within 2 hours

Initiated by a Specialist, Family Physician or Health Care Practitioner. Verbal, real-time response within 2 hours of the initiating physician’s or practitioner’s request

Notes:

i) Payable for telephone, video technology or face to face communication only. Not payable for written communication (i.e. fax, letter, email).
ii) Document time of initiating request, time of response, as well as advice given and to whom.
iii) Include the practitioner number of the physician or Health Care Practitioner requesting the advice in the "referred by" field when submitting claim..
iv) Not payable in addition to another service on the same day for the same patient by same practitioner.
v) Limited to one claim per patient per physician per day.
vi) Not payable if there is a paid visit/service for the same condition by the same practitioner in the previous 180 days.

10002 - Specialist Advice for Patient Management within one week

Initiated by a Specialist, Family Physician, Allied Care Provider, or coordinator of the patient’s care. Verbal real-time response in 7 days of initiating request - per 15 minutes or portion thereof

Notes:

i) Payable for telephone, video technology or face-to-face communication only. Not payable for written communication (i.e. fax, letter, email.)
ii) Document date of initiating request, date of the response, as well as advice given and to whom.
iii) Document start and end times in the medical record, and in time fields when submitting claim.
iv) Include the practitioner number of the physician or Allied Care Provider requesting advice in the "referred by" field when submitting claim. (For Allied Care Providers not registered with MSP use practitioner number 99987.)
v) Not payable in addition to another service on the same day for the same patient by the same practitioner.
vi) Limited to two services per patient per physician per week.
vii) Not payable if there is a paid visit/service for the same condition by the same practitioner in the previous 30 days.

10003 - Specialist Patient Management / Follow-up - per 15 minutes or portion thereof

Notes:

i) For verbal, real-time telephone and video technology communication (including other forms of electronic verbal communication) only. Not payable for written communication (i.e. fax, letter, e-mail).
ii) Documentation in the medical record to show that the patient understood and acknowledged the information provided.
iii) Include start and end times in the medical record, and in time fields when submitting claim.
iv) Face-to-face service must have been billed for the same patient by the same physician within the preceding 18 months.

10004 - Multidisciplinary Conferencing for Complex Patients - per 15 minutes; maximum one hour

Notes:

i) Each Specialist involved in the case conference must document their contribution to the discussion and its effects on the patient’s overall care in the medical record/chart.
ii) Start and end times of the conference must be documented in both the medical record and in time fields when submitting the claim.
iii) The names and job titles of the other participants at the meeting must be documented in the medical record.
iv) Maximum 16 services per patient per physician per calendar year.
v) Maximum of 4 services may be claimed per patient per physician per day.
vi) Case must be complex, as defined in the Eligibility.
vii) Use the ICD-9 code for one of the major disorders when billing.
viii) If patient has non-medical co-morbidity (see Eligibility) use the ICD-9 code M04 when billing.

10005 - Specialist Email Advice for Patient Management within one week

Initiated by a Specialist, Family Physician or Allied Care Provider. Response within 7 days of request

Notes:

i) Payable for email communication only. Maximum 3 services per patient per physician per day.
ii) Document date of request, date of the response, as well as advice given and to whom.
iii) Include the practitioner number of the physician or Allied Care Provider requesting advice in the "referred by" field when submitting claim. (For Allied care Providers not registered with MSP use practitioner number 99987).
iv) Not payable in addition to another service on the same day, for the same patient by same practitioner.
v) Limited to 3 services per patient per physician per day.
vi) Limited to maximum of 12 services per patient per physician per year.
vii) Not payable if there is a paid visit/service for the same condition by the same practitioner in the previous 30 days.

10006 - Specialist Email Patient Management / Follow-up

Notes:

i) This fee applies to email communication only.
ii) Maximum of 3 services per patient per physician per day.
iii) Maximum of 12 services per patient per physician per calendar year.
iv) Face-to-face service billed for the same patient by the same physician within the preceding 18 months.

10007 - Specialist Email/Text/Telephone Medical Advice Relay or ReRX Fee

Notes:

i) Email/Text/Telephone Relay Medical Advice requires two-way relay/communication of medical advice from the physician to eligible patients, or the patient's medical representative, via email/text or telephone. The task of relaying the physician advice may be delegated to any Allied Care Provider or MOA working within the physician's practice.
ii) Chart entry must record the name of the person who communicated with the patient or patient's medical representative, as well as the advice provided, modality of communication and confirmation the advice has been received.
iii) Payable for prescription renewals without patient interaction.
iv) Not payable for notification of appointments or referrals.
v) Only one service payable per patient per day.
vi) Not payable on the same calendar day as a visit or service fee by same physician for same patient.
vii) Not payable to physicians working under an Alternative Payment/Funding model whose duties would otherwise include provision of this service.

10009 - Specialist Advice for Patient Management on patient with previous visit/service within one week

Initiated by a Specialist, Family Physician, Allied Care Provider, or coordinator of the patient’s care. Verbal real-time response within 7 days of initiating request

Notes:

i) Payable for telephone, video technology or face to face communication only. Not payable for written communication (i.e. fax, letter, email).
ii) Document date of initiating request, date of the response, as well as advice given and to whom.
iii) Include the practitioner number of the physician or Allied care Provider requesting advice in the [referred by] field when submitting claim. (For Allied Care Providers not registered with MSP use practitioner number 99987).
iv) Not payable in addition to another service on the same day for the same patient by the same practitioner.
v) Limited to one claim per patient per physician per day and two services per patient per physician per week.

Creating a List of Favourites

With Dr. Bill you have the option of "starring" your most commonly used billing items, diagnostic codes, or referring physicians. Using our star feature will populate your starred items at the top of your lists for easy searching.

Just tap the star icon next to the billing item or diagnosis when searching your list. It'll be saved for next time. 

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