Claim Submission & Payment
Practitioners submit claims for services provided to beneficiaries to the Medical Services Plan (MSP) through the Teleplan system.
Teleplan is a web based telecommunications system which allows practitioners to securely submit claims, notes, retrieve remittance information and check patient eligibility over an encrypted Internet connection from MSP.
Billing and Payments
MSP accepts claims for medically required services that are MSP benefits, provided by practitioners who are enrolled with MSP and in good standing with the licensing body governing their profession.
MSP pays practitioner claims in accordance with the provisions of the Medicare Protection Act and Regulations, the relevant payment schedule, and MSP claims policy and procedures. The fees in the payment schedules are established through consultation between Medical Services Commission and the respective professional associations.
Assignment of New Teleplan Data Centre Numbers
Data Centre numbers for practitioner claims are currently defined throughout the MSP Claims system as an alphanumeric character field of five in length, beginning with T, M or V. No later than July 31, 2022, the format of Data Centre numbers will be expanded to include alphanumeric strings starting with other letters.
This work will include:
- Updating MoH and HIBC systems and processes that make use of Data Centre numbers, to accommodate numbers starting with other letters; and
- Updates to the Teleplan specifications.
Other Data Centre number parameters, including field length, will remain the same. Impacts to internal and external stakeholders are expected to be minimal. Data Centres already issued a number will retain those numbers with no impacts.
Current Teleplan specifications require the Data Centre number to start with T, M or V. Stakeholders whose code requires the field to start with T, M or V, or whose system logic depends on a value starting with T, M or V, must reconfigure the software to accept other letters as soon as possible.
No joint system or end-to-end testing is planned for this transition. Stakeholders are expected to complete testing internally to confirm that coding and configuration allow the new Data Centre number by no later than the deployment date above.
Replacement of Service Location Code 'A'
Effective April 1, 2021, Service Location Code A (Practitioner’s Office) for submitting practitioner claims was replaced with new codes, allowing the Ministry of Health to collect data related to service locations in greater detail.
The new location codes are:
(B) Community Health Centre
(J) First Nations Primary Health Care Clinic
(K) Hybrid Primary Care Practice (part-time longitudinal practice, part-time walk-in clinic)
(L) Longitudinal Primary Care Practice (e.g. GP family practice or PCN clinic)
(N) Health Care Practitioner Office (non-physician)
(Q) Specialist Physician Office
(U) Urgent and Primary Care Centre
(V) Virtual Care Clinic
(W) Walk-In Clinic
Claims submitted with Service Location Code 'A' for services provided after September 30, 2021 will be refused. Practitioners should consult with their Teleplan vendors to ensure that required changes to the Service Location Code field are in accordance with updated Teleplan specifications.
If you have any questions about this change, contact HIBC. For further information on selecting the correct Service Location Code, please see the How To Guide (PDF, 120KB).
Change to newly issued practitioner and payee numbers value, and specialty codes value: Effective June 1, 2022
A forecast conducted by the Ministry of Health (MoH) and Health Insurance BC (HIBC) has determined that available practitioner and payee numbers will be depleted by 2023. Practitioner and payee numbers are currently defined throughout the MSP Claims system as a character field of five in length, with values ranging from 00000 to 99999. Once depleted, it will no longer be possible to register new practitioners in BC.
To expand the range of available practitioner and payee numbers, new numbers issued starting June 1, 2022 will be issued as alphanumeric values. Current Teleplan specifications require the practitioner and payee number to be in character format. Teleplan vendors whose code limits the field to numeric characters, or whose system logic depends on a numeric-only value, must reconfigure their software to accept alphanumeric values by June 1, 2022.
MoH conducted an additional forecast of available practitioner specialty codes. Projections indicate that a minimum of 20 new specialty codes will be needed over the next five years, resulting in a shortage of available codes.
To expand the range of available specialty codes, new codes issued starting June 1, 2022, will also be issued as alphanumeric values.
If you have any questions or if you experience any issues submitting claims on or after June 1, 2022, please contact your Teleplan vendor; or contact HIBC.
In certain circumstances, MSP may reject, reduce or refuse payment on a claim submitted by a health care practitioner. In each case, explanatory codes accompany the rejection, reduction or refusal in order to provide the practitioner with the reason for their claim not being paid in full.
Designated Holidays and Close-Off Dates
When practitioners are preparing to submit their claims to MSP, it is important to note the MSP-designated holidays and close-off dates as they impact claims submission. Designated holidays impact certain claims such as the Out-of-Office Hours Premiums fee items while close-off dates are the designated semi-monthly cut-offs for claims submission through Teleplan. Claims should be submitted by close-off dates in order to be processed on the next remittance statement.