archive-org.com » ORG » A » ALBERTADOCTORS.ORG

Total: 974

Choose link from "Titles, links and description words view":

Or switch to "Titles and links view".
  • Transfer of Care | Alberta Medical Association
    may claim for services on the date of transfer if they have seen the patient The TOC modifier is added to visit service claims 03 03D by the receiving physician to indicate a transfer of care from one physician to another Adding the TOC modifier is only necessary if the transferring physician has claimed 03 03D on the same date of service as the receiving physician Fee codes for transfer of care Each of the following fee codes has specialty restrictions 03 03AO may only be billed by CARD CLIM GNSG E M HEM INMD MDON and RSMD 03 03AU may only be claimed by ORTH GNSG and UROL Fee code 03 03AI does not have a specialty restriction However this fee code may only be claimed in a functional centre ICU This fee code may not be claimed for the following Weekend coverage May not be claimed within 24 hours of an admission consultation or visit by the same physician on the same date of service Additional information Transfer of care fee codes may only be claimed when there is direct attendance by the physician The TOC modifier does not provide an additional fee it only allows two physicians to claim 03 03D for the same patient on the same date of service For transfer of care in the emergency department Review Follow up Visits in Emergency UCC or AACC Related fee codes 03 03AO Transfer of care of hospital inpatient May only be claimed by endocrinology metabolism general internal medicine general surgery cardiology hematology clinical immunology medical oncology and respiratory medicine May be claimed on the date of transfer by the receiving physician when assuming responsibility for care of a hospital inpatient May only claim one transfer per patient per calendar week regardless of whether the same or different physician provides the service The physician from whom the care is being transferred may claim a hospital visit or intensive care visit on the day of transfer May not be claimed for weekend coverage or within 24 hours of admission to hospital May not be claimed in the post operative time period unless complications occur 03 03AU Transfer of care of hospital in patient or out patient to operating physician May only be claimed by orthopedics general surgery and urology May only be claimed when a consultation for the patient has already been claimed by another physician of the same specialty May be claimed in addition to a procedure on the same date of service 03 03AI Transfer of care of intensive care patient May be claimed on the date of transfer by the receiving physician when assuming responsibility for care of an intensive care patient Only one transfer may be claimed per patient per calendar week regardless of whether the same or different physician provides the service The physician from whom the care is being transferred may claim a hospital visit or intensive care visit as appropriate on the day of transfer May not be claimed for weekend

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/online-billing-advice/transfer-of-care (2016-02-01)
    Open archived version from archive


  • 03.04J Complex Care Plan | Alberta Medical Association
    Hands Physician Advocacy Immunization Other Patient Health Matters albertapatients Forms Website and login help Media Publications Member Sign in AMA member number Password Forgot your password Login help Alberta Medical Association Member Sign in AMA member number Password Forgot your password Login help About the AMA Leaders Partners Member services Patients First Home Member services Physicians Compensation and billing Billing help Billing tips 03 04J Complex Care Plan 03 04J Complex Care Plan Physicians claiming the 03 04J Complex Care Plan must be the patient s regular physician of record and must intend to continue to provide ongoing comprehensive care of the patient for their conditions outlined in the comprehensive care plan Be sure to explain to the patient that you are completing a care plan for them and that you intend to provide ongoing care for their conditions Prior to starting the care plan physicians are encouraged to ask their patients if they are aware of any other physician that has completed a care plan for them in the last year Please note As of April 1 2014 03 04J now includes a re evaluation and revision of the plan within a year but no less than 345 days Updated Complex Care Plan Template Note Some browsers have difficulty opening this pdf If you cannot open the file try viewing this page in Internet Explorer or right click save the file to your computer and open it with Adobe Acrobat Website feedback Member services Physicians Our Agreements Compensation and billing Billing help Schedule of Medical Benefits Online Billing Advice Billing tips How to bill for major portion thereof Lacerations 98 22A and 98 22B Goals of Care forms Dental pre op and related services After hours work over 2016 stat holidays WCB report fee adjustments coming April 1 and

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/billing-tips/03.04J-complex-care (2016-02-01)
    Open archived version from archive

  • 03.04J Complex Care Plan expanded | Alberta Medical Association
    login help Media Publications Member Sign in AMA member number Password Forgot your password Login help Alberta Medical Association Member Sign in AMA member number Password Forgot your password Login help About the AMA Leaders Partners Member services Patients First Home Member services Physicians Compensation and billing Billing help Billing tips 03 04J Complex Care Plan expanded 03 04J Complex Care Plan expanded Chronic renal failure The Complex Care Plan has been expanded to include chronic renal failure defined as stage 2 renal failure A patient is considered to be at stage 2 chronic renal failure when there is a mild reduction in GFR 60 89 mL min 1 73 m2 with a presence of kidney damage A kidney is considered damaged when there are confirmed pathological abnormalities or markers of damage including abnormalities in blood or urine test or imaging studies Download the updated template to include chronic renal failure Note Some browsers have difficulty opening this pdf If you cannot open the file try viewing this page in Internet Explorer or right click save the file to your computer and open it with Adobe Acrobat The rules for claiming the 03 04J remain the same the patient must have two or more qualifying conditions one from column A and one from column B or two from column A The diagnostic codes for chronic renal failure are 585 Chronic renal failure For more advice from AMA staff on any billing issues including explanations of recent billing changes please email AMA billing staff Website feedback Member services Physicians Our Agreements Compensation and billing Billing help Schedule of Medical Benefits Online Billing Advice Billing tips How to bill for major portion thereof Lacerations 98 22A and 98 22B Goals of Care forms Dental pre op and related services After hours work

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/billing-tips/03.04J-complex-care-plan-expanded (2016-02-01)
    Open archived version from archive

  • After-hours time premium maximums | Alberta Medical Association
    03 01AA Learn more This code may only be claimed for physician services provided to patients in active treatment hospitals nursing homes or auxiliary hospitals AACC UCC in the after hours After hours is defined as 5 p m to 7 a m on weekdays and any time on weekends or statutory or designated holidays Patient must have been seen on the same date of service Activities that are included in claiming for time Charting Reviewing but not waiting for lab or DI results Consulting with other health providers on the service about the patient s care Writing a referral consultant letter Any other physician activities included in managing the patient s care Bill at the start of the encounter or during the time period where the bulk of the time was spent e g if the encounter starts at 2155 and ends at 2210 claim 03 01AA TNTP01 If the time spent managing patient care crosses over two time periods more than one modifier can be used e g if the encounter starts at 2100 and ends at 2345 claim 03 01AA TEV04 TNTP07 If the time spent managing patient care crosses two dates of service separate the claim into two claims with two dates of service For example if the encounter starts on day one at 2100 and ends on day two at 0045 the claim would look like this Claim one for day one 03 01AA TEV04 TNTP08 Claim two for day two 03 01AA TNTA03 These fee codes may not be claimed for the following Stand by time Completing discharge summaries or clinical notations after the patient has been discharged unless the patient was seen on the same day More than four units per hour per physician may not be claimed the time claimed cannot exceed actual time spent managing patient care Providing uninsured services Non physician time Additional information This HSC is claimed on a time basis and pays strictly for the time spent managing the patient s care in relation to an insured service 03 01AA is claimed in 15 minute units Only the time that the physician actually spent managing patient care is billable 03 01AA is billable in addition to other services at the same encounter on the same date of service for after hours work Modifiers that apply to 03 01AA are as follows TEV weekdays 1700 2200 Maximum of 20 units TNTP 2200 2400 Maximum of 8 units TNTA 2400 0700 Maximum of 28 units TWK weekends 0700 2200 Maximum of 60 units TST 0700 2200 statutory holidays Maximum of 60 units TDES designated statutory holidays 0700 2200 Maximum of 60 units A claim for 03 01AA must include a modifier that signals the time of day and the length of time it took to provide the service For example if the service started at 2015 hours and took 45 minutes the claim for 03 01AA would look like this HSC 03 01AA modifier TEV03 The TEV portion of the

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/billing-tips/billing-premium-maximums (2016-02-01)
    Open archived version from archive

  • After-hours time premium 03.01AA in active treatment hospitals, nursing homes or auxiliary hospitals | Alberta Medical Association
    as follows Patient must have been seen on the same date of service Activities that are included in claiming for time charting reviewing but not waiting for lab or DI results consulting with other health providers on the service about the patients care writing a referral consultant letter and any other activities that are included in managing the patients care To be billed at the start of the encounter or during the time period where the bulk of the time was spent e g for starting the encounter at 21 55 and ending at 22 10 claim 03 01AA TNTP01 If the time spent managing patients crosses over two time periods more than one modifier can be used e g for starting at 21 00 and ending at 23 45 claim 03 01AA TEV04 TNTP07 If the time spent managing patient care crosses two dates of service separate the claim into two claims with two dates of service e g for starting on day one at 21 00 and ending on day two at 03 45 claim 03 01AA TEV04 TNTP08 for day one and 03 01AA TNTA15 for day two 03 01AA may not be claimed for the following Stand by time Completing discharge summaries or clinical notations unless the patient was seen on that day More than 4 units per hour per physician may not be claimed Time claimed cannot exceed actual time spent managing patient care Providing uninsured services Additional information This HSC is claimed on a time basis and pays strictly for the time spent managing the patients care in relation to an insured service 03 01AA is claimed in 15 minute units A claim for 03 01AA must include a modifier that signals the time of day and the length of time it took to

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/billing-tips/after-hours-time-premium-billing-tip (2016-02-01)
    Open archived version from archive

  • After-hours work: Billing for before and after midnight | Alberta Medical Association
    Website and login help Media Publications Member Sign in AMA member number Password Forgot your password Login help Alberta Medical Association Member Sign in AMA member number Password Forgot your password Login help About the AMA Leaders Partners Member services Patients First Home Member services Physicians Compensation and billing Billing help Billing tips After hours work Billing for before and after midnight After hours work Billing for before and after midnight Time spent with the patient before and after midnight must be submitted using two 03 01AA claims using two different dates of service For example if the encounter begins March 10 at 2300hrs and ends March 11 at 0015hrs then in addition to the claim for the service the claim for the after hours time premium should be entered using the two dates of service After hours time premium Claim 1 March 10 03 01AA TNTP04 After hours time premium Claim 2 March 11 03 01AA TNTA01 Please do not forget that the total time premiums claimed cannot exceed the total time spent managing patient care for that shift For example if the total after hours time spent in the hospital was 10 hours subtract the time spent eating dinner and other non patient related activities The remainder will be the total time spent managing patient care and therefore the maximum period of time that is eligible for time premiums Submitting claims for time premiums that total more time than was actually spent managing patient care is considered inappropriate billing Website feedback Member services Physicians Our Agreements Compensation and billing Billing help Schedule of Medical Benefits Online Billing Advice Billing tips How to bill for major portion thereof Lacerations 98 22A and 98 22B Goals of Care forms Dental pre op and related services After hours work over 2016

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/billing-tips/midnight (2016-02-01)
    Open archived version from archive

  • After-hours work over 2015 stat holidays | Alberta Medical Association
    0700 2200 hours NTPM 2200 2400 hours TST 0700 2200 TNTA 0000 0700 TNTP 2200 2400 Monday August 3 2015 Alberta Heritage Day NTAM 0000 0700 hours WK 0700 2200 hours NTPM 2200 2400 hours TST 0700 2200 TNTA 0000 0700 TNTP 2200 2400 Monday September 7 2015 Labour Day NTAM 0000 0700 hours WK 0700 2200 hours NTPM 2200 2400 hours TST 0700 2200 TNTA 0000 0700 TNTP 2200 2400 Monday October 12 2015 Thanksgiving Day NTAM 0000 0700 hours WK 0700 2200 hours NTPM 2200 2400 hours TST 0700 2200 TNTA 0000 0700 TNTP 2200 2400 Wednesday November 11 2015 Remembrance Day NTAM 0000 0700 hours WK 0700 2200 hours NTPM 2200 2400 hours TST 0700 2200 TNTA 0000 0700 TNTP 2200 2400 Friday December 25 2015 Christmas Day NTAM 0000 0700 hours WK 0700 2200 hours NTPM 2200 2400 hours TST 0700 2200 TNTA 0000 0700 TNTP 2200 2400 Saturday December 26 2015 Boxing Day NTAM 0000 0700 hours WK 0700 2200 hours NTPM 2200 2400 hours TST 0700 2200 TNTA 0000 0700 TNTP 2200 2400 Monday December 28 2015 Designated Holiday for Boxing Day NTAM 0000 0700 WK 0700 2200 NTPM 2200 2400 TNTA 0000 0700 TDES 0700 2200 TNTP 2200 2400 Callback codes for holidays These callback codes are selected as they are relevant to statutory and designated holidays For a complete list of callback codes please consult the Schedule of Medical Benefits Reminder The physician must be located outside of the facility property at the time of the call in order to claim a callback Callbacks for hospital emergency outpatient department AACC UCC auxiliary hospital or nursing home should be submitted as 03 03LA between 0700 2200 hours designated holidays and statutory holidays 03 03MC between 2200 2400 hours 03 03MD between 2400 0700 hours These callbacks are also billed in addition to a visit code 03 02A 03 03A 03 03B 03 04A and 03 03EA as appropriate Callbacks for hospital inpatients should be submitted as 03 05R between 0700 2200 hours designated holidays and statutory holidays 03 05QA between 2200 2400 hours 03 05QB between 2400 0700 hours These callbacks are also billed in addition to a visit code 03 03DF Surcharge Information The AMA would like to remind physicians that in order to claim for surcharges you must meet all of the following criteria Special call for attendance Respond to the call on an unscheduled basis outside of normal working hours Patient is attended on a priority basis There is direct attendance by the physician see GR 15 for full details 03 01AA Information If a service crosses multiple time periods use more than one modifier on the claim e g service start time 2115 hours end time 2245 hours the claim submitted would be 03 01AA modifier one TEV03 modifier two TNTP03 If a service crosses dates split the claim for 03 01AA into two claims with two separate dates of service e g start time day one 2300 hours

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/billing-tips/After-hours-work-over-2015-stat-holidays (2016-02-01)
    Open archived version from archive

  • Are you claiming the right injections? | Alberta Medical Association
    Support Program PFSP Practice Management Program PMP AMA Physician Locum Services Insurance Wealth management Do the paperwork Resident Physicians Medical Students Membership Guide Manage your membership Patients First Advocacy timeline Health issues Prescription Alberta Many Hands Physician Advocacy Immunization Other Patient Health Matters albertapatients Forms Website and login help Media Publications Member Sign in AMA member number Password Forgot your password Login help Alberta Medical Association Member Sign in AMA member number Password Forgot your password Login help About the AMA Leaders Partners Member services Patients First Home Member services Physicians Compensation and billing Billing help Billing tips Are you claiming the right injections Are you claiming the right injections Injections for tetanus may only be claimed to Alberta Health and Wellness AHW when they are provided as a part of wound management Patients may be referred to a Public Health Clinic for their tetanus or booster injections Other injections that are not billable to AHW are hepatitis travel Gardasil Please refer to Med Bulletin 67 for more information regarding insured injections Please note Claims may only be submitted for insured injections if the physician provides the injection Injections provided by the nurse are not billable to AHW with the exception of flu or pneumococcal vaccinations Website feedback Member services Physicians Our Agreements Compensation and billing Billing help Schedule of Medical Benefits Online Billing Advice Billing tips How to bill for major portion thereof Lacerations 98 22A and 98 22B Goals of Care forms Dental pre op and related services After hours work over 2016 stat holidays WCB report fee adjustments coming April 1 and July 1 2016 Billing seminars Compensation programs Uninsured services Allocation Alternative Relationship Plans ARPs Economic indicators WCB Physician and Family Support Program PFSP Practice Management Program PMP AMA Physician Locum Services Insurance Wealth management Do

    Original URL path: https://www.albertadoctors.org/services/physicians/compensation-billing/billing-help/billing-tips/right-injections (2016-02-01)
    Open archived version from archive