Soft Opt Out

MSP Reimbursement Directed Back to Practitioner

Option 1a - Electronic (Teleplan) Billing Only

General Information

• Reimbursement for MSP services is paid twice a month
• Practitioner must bill electronically (Teleplan)
• Can have direct bank deposit (DBD) or receive a manual cheque twice a month
• An agreement between MSP and practitioner must be in place (third party agreement)
• An agreement needs to be in place for every associated payment number and practitioner number (i.e. if you have a locum or associate working in your office)
• must have an Authorization for Payment From Medical Services Plan to Opted-Out Practitioners (PDF, 607KB) form signed by patient and retained in each file where MSP is the insurer
• Remittance statements sent electronically twice a month

As required by legislation practitioners must inform patient:

• that the practitioner has opted out
• how much the patient will be reimbursed by MSP
• how much, if any, the patient will be paying in addition to MSP fee

Checklist

• Send a letter to HIBC requesting Option 1a Soft Opt Out status.
• Check with software vendor to see if your software can submit claims in opted out format.
• Complete an Application for Teleplan Service – Opted Out (HLTH2771) (PDF, 125KB).
• Ensure address on the electronic claim record is your practitioner address (contact your software vendor).
• Inform the patient that you are opted out and how much they will be paying you in addition to the MSP fee.
• Complete an Authorization for Payment From Medical Services Plan to Opted-Out Practitioners (PDF, 607KB) form signed by patient and retain in each file where MSP is the insurer.
• Complete Agreement between Practitioner and MSP form (Third party agreement) and mail or fax to MSP.
• HIBC will provide you with the date of your “opted out status” and that is the date that should be on your Agreement between Practitioner and MSP form.
• Agreement form must be completed for every associated payment number and practitioner number in your office – then mail or fax form(s) to MSP.
• If you chose to direct deposit, a Direct Deposit (DBD) form must be completed and returned to MSP along with a copy of a void cheque.
• If you do not choose DBD and do not complete the form, you will receive one cheque, twice a month.
• Remittance statements are sent twice a month.
• Prior to submitting claims for the first time, contact HIBC at 604-456-6950 in Vancouver or 1 866 456-6950 for the rest of BC to make sure that all applications have been processed.

Option 1b - Electronic Billing (Teleplan) or Online Submission

General Information

• Reimbursement for MSP services is made once a month, at the end of the month.
• Multiple cheques are sent to practitioner’s office each month is patient’s names with the practitioner’s address.
• Practitioners should confirm their financial institution accepts such third party cheques.
• Practitioner may bill electronically (Teleplan) or through online submission.
• Practitioner must have an Authorization for Payment From Medical Services Plan to Opted-Out Practitioners (PDF, 607KB) form signed by each patient and retained in each file where MSP is the insurer.
• Complete an Application for Teleplan Service – Opted Out if billing electronically (Teleplan).
• Check with software vendor regarding opted out format.
• No direct deposit option.
• No Agreement between Practitioner and MSP form (Third party agreement) required.

As required by legislation practitioners must inform patient:

• that the practitioner has opted out
• how much the patient will be reimbursed by MSP
• how much, if any, the patient will be paying in addition to MSP fee

Checklist

• Send a letter to HIBC requesting Option 1b Soft Opt Out status.
• Claims can be billed electronically (Teleplan) or through online submission. If billing electronically (Teleplan), check with software vendor to see if your software can submit claims in opted out format.
• If billing electronically (Teleplan), complete an Application for Teleplan Service – Opted Out (HLTH2771) (PDF, 125KB).
• Inform the patient that you are opted out and how much they will be paying you in addition to the MSP fee.
• Cheque is made out in patient’s name and practitioner’s address – ensure the address on the claim is that of the practitioner’s office (you may need to check with your software vendor).
• Payment is made by multiple cheques sent once a month in the name of each patient.
• No remittance statement is sent if billing through online submission.
• If billing electronically (Teleplan), payments are once a month and remittance statements are sent electronically.
• Make sure your financial institution accepts multiple cheques made out to third parties.
• Prior to submitting claims for the first time, contact HIBC at 250 456-6950 in Vancouver or 1 866 456-6950 for the rest of BC to make sure that all applications have been processed.