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 enroled 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.
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.