GPSC has released its final Visioning Engagement Report, outlining what it heard from the thousands of GPs who participated in the visioning process last year. GPSC has agreed to work towards incenting and supporting family doctors to transition to a BC version of the CFPC Patient Medical Home model. This will be the focus of its work for the upcoming year.
Meanwhile, in a parallel universe, the Ministry of Health has directed Health Authorities to work with local Divisions of Family Practice to deliver plans by June 1 on how to implement Primary Care Homes across BC in the next 3 years. SGP believes that Patient Medical Homes live within Primary Care Home neighbourhoods and wants everyone to get outside their four walls and work together to realise the vision together: family docs; GPSC; Health Authorities; MOH.
How can we create a Patient Centred healthcare system if we don’t travel together down the same road?
Doctors of Technology Office (DTO) has replaced PITO. What does it do?
DTO: Helping physicians ensure technology works for them
Doctors Technology Office (DTO), a joint initiative of the General Practice Services Committee and the Specialist Services Committee supports BC physicians with their in-practice technology needs. Physicians can receive advocacy support and guidance around use of technology in their practices, with a primary focus on Electronic Medical Records (EMR).
Physicians are encouraged to contact DTO for assistance with major unresolved technical issues such as accessing EMRs from hospitals or facilities, or connecting EMRs and local networks. When a solution to the reported issue cannot be found or resolved in a timely manner through their EMR vendor, physicians can contact DTO, which will work with other partners towards finding a solution on behalf of physicians.
In addition, DTO investigates new technology and recommends solutions to reduce security and performance issues, and works with provincial partners to ensure the physicians’ voice is represented when designing and delivering technology solutions for BC health care. Contact DTO – Technology Solutions and Support at 604 638 5841 or email: doctors technology office support. For the latest DTO technical bulletin, click here.
SGP has received many questions about clauses in EMR contracts related to patient privacy issues, data sharing, patient portals and more. There is need for clear policy to help physicians navigate these waters. Specific to Telus contracts, CMPA provided physicians with some advice. Click to read more.
It’s that time of year again – when we renew our hospital privileges. And it’s the first time for all of us under the single, standardized web-based Provincial Practitioner Credentialing and Privileging (C&P) System, i.e. CACTUS Software. Many of you have questions about the process and the Family Medicine/General Practice Privileging Dictionary. You can find lots of information on the BC Medical Quality Initiative website. SGP is interested in hearing about your experience with the new process: email us at email@example.com
As of Nov. 1, 2015 you are required to record the start and end time for a prolonged counseling visit (0120 series) in the patient’s medical record, and to submit those times with your billing claim to MSP. This change was made in order to protect GPs in the case of audit.
We know that many of you feel swamped by paperwork, including documentation requirements for fees. However, the change is considered necessary in order to protect GPs in the case of audit. Medical inspectors look for documentation to support the billing criteria for any fee, and in the case of the 0120, there is a requirement for a minimum of 20 minutes. Requiring start/end times to be submitted and recorded for the 0120 series brings the fees into line with the GPSC Mental Health Management fees (14044-14048) which have the same requirements.
SGP has heard from some members that when they “google” CSHA frailty score, they find information on scores of 6 and 7 that seems to contradict that found in the description of fee code 14075. GPSC uses the scale contained in the GPAC guideline Frailty in Older Adults, revised January 2012. When you click on the links embedded in the SGP website, you are directed to the scale as it appears in the GPAC guideline, and you may rely on that.
On August 1, 2015 the General Practitioner Services Committee (GPSC) made revisions to the wording of some GPSC fees. Simplification of documentation requirements for the complex care fee were made Sept. 18.
Here are some of the key points:
1) There is no longer a requirement to give flowsheets to patients. Offer self-management supports as appropriate for individual patients.
GPSC notes: “Must have chart-documented provision of a clinically appropriate level of guideline-informed care in the preceding year, including patient self-management supports as appropriate for individual patients. Sharing of flow sheets no longer required, although the use of flow sheets (paper or electronic) as a tool for documentation is still considered an appropriate confirmation of care provision.”
2) For annual billing of CDM incentives, one of the two visits required in the preceding year can be a GPSC telephone visit or a group medical visit.
GPSC notes: “There must be at least 2 visit fees (office; prenatal; home; long term care; only one of which can be a GPSC Telephone Visit or a Group Medical Visit) in the 12 months prior to billing the CDM incentive. Visits provided by a locum are included; however, if the 2-visit requirement includes a locum visit, an electronic note must be submitted with the claim.”
3) Start and end times are now required for billing submission for mental health planning fees (14043) , palliative planning fees (14063) and mental health management fees (14044, 14045, 14046, 14047, 14048). The start and end times should also be recorded in the chart.
GPSC notes: “Minimum requirement of 30 minutes face-to-face time in addition to visit time (home/office) same day. Both chart and claim must state start and end times of the total service (planning + visit).”
4) For the Complex Care Planning fees 14033 and 14075, the chart note must include the total of : time spent planning (face-to-face, chart review and documentation) plus time spent for the required same day visit fee. Of this total, the majority must be face-to-face, and this majority time must also be charted.
GPSC notes: “Minimum required time 30 minutes to review chart and create the care plan jointly with the patient and/or their medical representative. The majority of the time must be face-to-face. Documentation in the patient chart of total time spent in planning (face to face; review) and medical visit is required.”
So, document a minimum of 35 minutes of total work time for the combined visit and planning.
The 35 combined minutes should include:
- at least 20 minutes of physician-patient face-to-face time
- plus any combination of:
- chart review
- more physician-patient face-to-face time
- encounter documentation
- allied care provider time with patient
For example: You spend 20 minutes face to face with the patient and 15 minutes on chart review and documentation.
Document: total time = 35 min, face to face time = 20 min
5) GP’s on Alternate Payment who bill encounter codes are now requested to use a different set of CDM codes when submitting for these services.
GPSC notes: “New codes for GPs who bill encounter codes are available retroactively to January 1, 2015. Please wait until after August 4, 2015 to resubmit any rejected CDMs with these new codes retroactively. Submission code “A” may be used for any claims over 90 days of age. The 2-visit requirements are subject to review of encounter codes to confirm provision of care.”
For the full details read GPSC’s summary of the changes.
SGP is interested to hear what you think of the GPSC’s changes. Send us your thoughts at: firstname.lastname@example.org
The SGP Board provided the following feedback to the Doctors of BC policy consultation process about the Ministry of Health Primary Care Policy Papers
SGP Board Response to Primary Care Policy Paper 2015
You can read the Ministry policy papers here
Send us your thoughts at SGP.Feedback@doctorsofbc.ca
SGP has posted updated uninsured services invoices with NEW rates for 2015 in the uninsured services package section of our website.
We have updated the Worksafe page of the SGP website to reflect the following changes:
Effective January 26, 2014: fee codes for submitting Form 8 and 11 have been simplified. Merely select the fee code matching which report form you are submitting (Form 8 or Form 11), and the method of your submission (electronic via Teleplan or non-electronic via fax or mail). It is no longer necessary to select a fee code that matches the timeliness of your submission. The timeline is determined automatically by WorkSafeBC.
Effective March 12, 2015: fee codes 19938, 19901, 19941, and 19903 will be obsolete. If the physician is invoicing electronically through Teleplan, the fee codes will not be an option in their invoicing software; they will have disappeared following update from MSP. If the physician is invoicing by fax or mail, the item will be rejected and the physician must resubmit the invoice using the correct fee code.
See WCB’s summary: New WorksafeBC Fee code changes
Check out more SGP Billing Tips in our Billing Tip Archive
You can read the primary-and-community-care-policy-paper or go to their library to read all 4 papers released Feb. 18: Delivering a Patient Centred, high performing and sustainable health system; Surgical Services; Rural Health Services and the primary care paper.
The FP/GP privileging dictionary work is ready for final feedback. Read it @ family-medicine-privileges- SGP is interested to hear feedback at email@example.com Colleagues representing the broad spectrum of family medicine work- urban, suburban and rural- have worked collaboratively to write the dictionary which will be implemented province wide for hospital privileging in Family Medicine. Organizations involved in the process included BCCFP; CFPC; Health Authorities; SGP; Doctors of BC; and Rural Issues Committee. Read more information on the Provincial Privileging Project @ www.privileging.typepad.com
G14019 NEW – GP-Nurse Practitioner Advice Fee Code $40.00
Billable by a family physician for providing advice to a nurse practitioner (NP), in cases where the NP requesting advice is the Most Responsible Provider for a patient’s care in the community.
If providing advice to an NP about a patient for whom you are the MRP (Most Responsible provider), see fee code: G14077.
Read more about 14019 NEW – GP-Nurse Practitioner Advice Fee Code.
Read more about All Case Conferencing Fee Codes,
Doctors of BC has released a new policy paper on Telemedicine in Primary Care.
To all of you who are participating in Attachment, it’s time to resubmit the 14070 Attachment Participation Code. By submitting this code you are reaffirming that you provide full service family practice to your patients and will continue to do so for the duration of 2015; and that you confirm the doctor-patient relationship with existing patients through a standardized conversation or “compact.” You do not need to re-notify your Division of Family Practice of your continued participation. If you need a refresher on how to submit the 14070:
PHN#: 975 303 5697
First name: Attachment
DOB January 1, 2013
See Details in our easy to use simplified guide to fees