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Business Cost Premium: Telehealth Fees Update

February 6, 2020

Effective May 1, 2020, the Business Cost Premium (BCP) will be temporarily expanded to apply to Telehealth fee items (phone and video). This is to ensure that the BCP is paid during the Covid-19 pandemic, given these services would have normally been provided in person in physician’s offices. Click here for more information. 

What is the BCP?

As agreed to in the 2019 Physician Master Agreement, effective April 1, 2020 eligible physicians will be able to claim a new BCP on fees for Consultation, Visit, Counselling and Complete Examination services to help cover the rising rent, lease, or ownership costs of a community-based office.

Who is eligible for the BCP? 

Physicians meeting the following criteria are eligible for the BCP:

  • Physician is responsible for some or all of the rent, lease, or ownership costs of a community-based office, either directly or indirectly. 
  • The community-based office is in an eligible geographical location, including but not limited to Vancouver, Victoria, Metro Vancouver, and Greater Victoria. Rural Retention Program (RRP) communities are not eligible. Please note: although the BCP isn’t available to rural communities, additional funding was directed to the Joint Standing Committee (JSC) on Rural Issues to address the matter of rising overhead costs for rural physicians. The JSC is still working on how it may direct funds to address this.
  • Physician bills eligible fee-for-service fee items (Consultation, Visit, Counselling and Complete Examinations).
  • Physician must be entitled to receive and retain payment for the eligible fees directly from MSP (e.g. payments assigned to Health Authorities are not eligible for the premium).

How is the BCP calculated? 

The percentage values and the daily maximum amounts of the BCP are based on the eligible fees and the location of the eligible community-based office in which the services are provided. As there is a fixed budget to implement the BCP, the following percentage values and daily maximum amounts may change as a result of uptake:

  • City of Vancouver: 5% of eligible fees up to a maximum BCP payment of $60 per day per physician.
  • Metro Vancouver (excluding the City of Vancouver) and Greater Victoria: 4% of eligible fees up to a maximum BCP payment of $48 per day per physician.
  • Other communities (outside Greater Vancouver and Greater Victoria) not eligible for the Rural Retention Premiums: 3% of eligible fees up to a maximum BCP payment of $36 per day per physician.

What fees are eligible?

The BCP will be applied to eligible fees for Consultation, Visit, Counselling and Complete Examination services. Due to COVID-19, the BCP can also be applied temporarily to telehealth fee items beginning May 1, 2020. You can find the full list of eligible fees here

How will the BCP be paid?

The BCP will be applied to eligible fees submitted on physician’s billing claims, and will be paid to the physician’s (or assigned) payee number. The claims system will apply the percentage for the premium and calculate the daily maximum. In order to identify the physical location in which services are provided and for the correct percentage premium to be applied, physicians will need to register their community-based office for a Facility Number, which is a unique physician/office location-identifier. 

If an eligible physician is responsible for some or all of the lease, rental, or ownership costs at more than one community-based location, the physician will need to register each location where eligible services are provided.

Obtain a Facility Number for the BCP

The physician responsible for administration of an eligible facility (the “Facility Administrator”) must apply for a Facility Number by submitting the “Application for MSP Facility Number (New)” form. Please ensure to check the box to request the BCP be applied to eligible fees paid to eligible physicians attached to that facility.  Each location must obtain a unique Facility Number.

Online application: https://my.gov.bc.ca/bcp/register-facility
Fill and print form: https://www2.gov.bc.ca/assets/gov/health/forms/2948fil.pdf 

Notes:

  • Ensure that only one application for a Facility Number is submitted for each facility.
  • The facility effective date is the date the clinic originally opened at its current location. If you don’t know this date, please use April 1, 2020.
  • A facility number must be assigned before submitting a Practitioner Attachment form, as this information is required for the form.

Attach a physician to a facility for the BCP

Once a facility has obtained a Facility Number, eligible physicians can be attached to the facility in order to claim the BCP.

Individual physicians (including, if applicable, the Facility Administrator) must declare their eligibility for the BCP for each facility at which they provide eligible services, by completing the “Practitioner Attachment to MSP Facility Number” form for each eligible location.

Online application: https://my.gov.bc.ca/bcp/practitioner-registration
Fill and print form: https://www2.gov.bc.ca/assets/gov/health/forms/2950fil.pdf 

Note: 

  • The Practitioner Attachment date is the date the physician is eligible to start receiving the BCP at the applicable office (e.g. April 1, 2020 or after).

Cancel or Change Details for a Facility

If there are any changes to the information for the facility after the application form has been submitted, the Facility Administrator must submit the “Application to Cancel or Change Details for Facilities with an MSP Facility Number” form.

Online application: https://my.gov.bc.ca/bcp/update-facility/home
Fill and print form: https://www2.gov.bc.ca/assets/gov/health/forms/2949fil.pdf

Application submission

Health Insurance BC (HIBC) administers the BCP and processes the applications on behalf of MSP. Applications can be submitted to HIBC online, or by fax or mail. The fax number and mailing address are at the bottom of the Fill and Print form. 

Resources for support:

  • Technical support (e.g. applications, registration confirmation):

    Health Insurance BC (HIBC)

    Vancouver: 604 456 6950

    Elsewhere in B.C.: 1 866 456 6950
     

  • General inquiries: economics@doctorsofbc.ca

Online BCP webinar: Recording from March 12 now available!

Click here: Recording Business Cost Premium Education Webinar March 12, 2020

Details covered in the session included eligibility criteria, how to register for a facility number, and EMR requirements for submitting BCP claims. 

FAQ's

ELIGIBILITY: WHO OR WHAT IS ELIGIBLE FOR BCP?

Are the two new temporary fee codes for COVID-19 eligible for the BCP?

Yes, fee codes T13701 (Office Visit for COVID-19 with test) and T13702 (Office Visit for COVID-19 without test) are both eligible for the BCP, as Visits are considered an eligible service under the BCP criteria.

If I receive Rural Retention Premiums (RRP), do I qualify for the BCP?

No, eligible locations include the city of Vancouver, Metro Vancouver, the greater Victoria area, and other communities not eligible for the RRP. There are other mechanisms in-place for funding in rural locations.

What qualifies as ownership costs?

Examples of ownership costs include mortgage, utilities, property taxes, etc. 

Are walk-in clinics eligible?

Yes, if the walk-in clinic is located in an eligible geographical location, and you are an eligible physician paying towards the lease, rent or ownership costs of the clinic.

There are multiple physicians working in a group clinic, with some paying towards business expenses and others who are not. How does that work?

Only the physicians who pay towards the rent, lease, or ownership costs of an eligible office would qualify for the BCP.

I work in a clinic but do not own it, do I qualify?

Yes, if it is an eligible clinic and you pay towards the lease, rent, or ownership costs.

INFORMATION FOR LOCUMS

I am working as a locum, do I qualify?

Yes, if you work in a clinic that qualifies and part of your agreement is to cover some of the lease, rent, or ownership costs. The payment will be paid to the Payee number you have assigned on the Assignment of Payment form. The payment should be distributed between the host physician/clinic and locum as per your agreement.

If I provide locum services in two different clinics on the same day, how will the BCP be paid? 

The BCP may be paid on multiple facility numbers.  The BCP daily maximum though is based on an individual practitioner. The BCP will paid to a practitioner maximum on whichever eligible claims are received first, regardless of facility or payee number.  If the maximum is reached on the first clinics claims, then no BCP is paid to the second clinic.  However, if the maximum is not reached for the first clinic, the remaining amount will be paid to the second clinic. 

Many locums complete an Assignment of Payment (AOP) form with a 1-year time range so that they don’t need to complete a new AOP each time they provide locum services at that clinic. Are precise dates required for the BCP form, or can locums do the same without impact on billings? 

No, precise dates are not needed for locums, they can put in the same dates as their AOP.  If circumstances change and the physician cancels their AOP, they should update their registration on the APPLICATION TO CANCEL OR CHANGE DETAILS FOR FACILITIES WITH AN MSP FACILITY NUMBER form.

FACILITY NUMBER: OBTAINING A FACILITY NUMBER AND ATTACHING A PHYSICIAN

When working as a locum, can I apply online for the BCP and Assignment of Payment at the same time? 

Not at this time. These are two separate forms. Practitioner attachment for the BCP can be completed online using a new electronic form, while the existing Assignment of Payment form must be submitted by Canada Post or fax.

What if I practice at more than one office?

If you practice at more than one eligible office (e.g. two offices) and pay towards the lease, rent, or ownership costs at both places, then you would be eligible for the BCP whenever you provide eligible services at either location. You must complete the Practitioner attachment for each unique eligible office.

REGISTRATION: APPLICATION QUESTIONS

Can I still register for the BCP after April 1, 2020?​

Yes. If your registration isn’t complete until after April 1, you have two options to claim the BCP:

  1. Hold your billing claims from April 1 onwards. Once your BCP registration has been completed (e.g. you have been assigned a facility number and completed the Practitioner Attachment process), submit your claims and the BCP will be applied to the eligible fees.
  2. Continue submitting your billing claims as you typically would, and once your BCP registration has been completed you can resubmit your claims from April 1 onwards to claim the BCP on eligible fees.
I received an error message saying the information on my application does not match MSP records. What does this mean?

This most likely means you have entered your Payee number in the MSP Practitioner Number field instead of your personal MSP Practitioner number.

The Application For MSP Facility Number asks for the Facility Effective Date. What is this?

This is the date the clinic/office originally opened at its current location. If you don’t know this date, please use April 1, 2020.

Who do I call if I experience technical difficulties with an application form?

You can call the HIBC Practitioner number for technical assistance with a form:
Vancouver: (604) 456-6950
Elsewhere in B.C.: 1-866-456-6950

PREMIUM: HOW WILL THE BCP BE PAID?

Where will my payment notification show up?

It will show up as a Level 1 adjustment on your remittance statement.

Can facility owners retain all of the BCP?

The BCP is an MSP payment and the sharing between physicians and clinic owners should be based on your current agreement regarding overhead costs, unless you agree to an alternative arrangement. The PMA clearly states that the BCP is for physicians, and therefore clinic owners cannot automatically retain all of the BCP.

Is the daily maximum per physician per location?

No, the daily maximum is per physician per day across all locations or facilities. 

OTHER QUESTIONS: EMR? CLAIMS SUBMISSION?

How do I know if my EMR has the capability or functionality to process the BCP?

The Doctors Technology Office is consulting with the EMR vendor-community to gauge readiness for implementation. However, as there are 100+ Teleplan certified billing vendors, it is recommended that physicians follow up with their billing software company/EMR vendor for information regarding their specific software as soon as possible.

Can an existing Teleplan field (e.g. data centre, service location code, MSP billing #) be used for BCP identification purposes, rather than having to register for a Facility Number?

No. Existing fields do not identify the physical location of the community-based office. After registration an office will be assigned a unique Facility Number. The new Facility Number is the best field for administering the BCP given the technical parameters of the Teleplan system. It is a “mandatory field” which means that every software provider is already required to have that field built into their product, although you may not see it right now.

I am preparing my billing claims for submission. What do I need to do, to start claiming the BCP?

In order to start claiming the BCP, please ensure the following steps are complete:

  1. You have a facility number and attached your practitioner number. 
  2. Your billing claim contains the following information:
    • The claim is for an eligible BCP fee item (the full list of eligible fees can be found here)
    • Facility code must be entered on claim
    • Service location code entered on claim must be: 
      • A — PRACTITIONER'S OFFICE - IN COMMUNITY
        These other service location codes will be accepted if the physician is responsible for some or all of the lease, rental, or ownership costs of that office:
      • DIAGNOSTIC FACILITY
      • F — PRIVATE MEDICAL/SURGICAL FACILITY
      • M — MENTAL HEALTH CENTRE
      • T — PRACTITIONER'S OFFICE - IN PUBLICLY ADMINISTERED FACILITY
What if I submit a procedure fee with the BCP facility number on my billing claim in error? Or, what if I submit all my claims that are a mix of eligible and non-eligible fees with a BCP facility number?

The claims system will be programmed to only apply the BCP to the eligible fee items submitted by eligible physicians. If you submit a non-BCP fee item, the system will process your claims in the usual manner and will not apply the premium.

What happens if I submit a claim with a facility number and I have not registered my practitioner attachment to the facility?

The claim will be refused with an explanation that the practitioner has not been attached to the facility number.

For any questions regarding the BCP, please contact economics@doctorsofbc.ca.​​