Claim Submission & Payment

Teleplan

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.

Replacement of Service Location Code A (April 1, 2021)

Effective April 1, 2021, Service Location Code A (Practitioner’s Office) for submitting practitioner claims will be replaced with new codes, allowing the Ministry of Health to collect data related to service locations in greater detail.

The new location codes will be:

(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

The change will be phased in over a six-month period, ending September 30, 2021. Practitioners using Service Location Code A are encouraged to use the new codes starting April 1, 2021; however, it will continue to be valid from April 1, 2021 to September 30, 2021. 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 completed on time and in accordance with updated Teleplan specifications. 

Vendors who have hard-coded Service Location Code A (Practitioner’s Office) for the Service Location Code must complete one of the following changes:

  • expand the options choices to include the new codes; 
  • program in the new code applicable to the relevant practice; or
  • leave the location field blank, allowing practitioners to enter the code that applies to them.

The Ministry of Health will provide ongoing information and support for vendors to develop, test and deploy any required changes. If you have any questions about this change, contact HIBC.

Change to newly issued practitioner and payee numbers value: Effective April 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. Unless there are changes to this field, once the existing pool of numbers are 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 April 1, 2022 will be issued as alphanumeric values. The number of characters in practitioner and payee numbers (five) will remain unchanged, and numbers issued before April 1, 2022 will remain valid.

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 April 1, 2022.

The Ministry of Health will provide ongoing information and support for vendors to develop, test and deploy any required changes. If you have any questions about this change, contact HIBC. 

Explanatory Codes

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.