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A few months ago, we informed you of the RAMQ’s guidelines regarding the new billing instructions for time supplements (rule 1 of Addendum 1 and rule 2.8 of Addendum 4). Recently, we contacted the RAMQ following several questions related to refusals for inpatient or emergency clinic claims for which the end time was not indicated on the claims and here is what the RAMQ mentioned:
In order for the time supplement to be paid, you must enter the start and end times for all your visits between 7:00 a.m. to 7:00 p.m., in the same establishment, even for visits made on the ward and in the Emergency Room.
According to the RAMQ, do not take into account the following sentence:
However, this requirement does not apply to visits and consultations performed in in-patient or in the emergency room of a short-term care facility.
We are currently trying to contact the FMSQ to get more details on this issue. In the meantime, it would be important to record the start and end times of each visit between 7:00 a.m. to 7:00 p.m., in the same establishment, even for visits made on the ward and in the Emergency Room. We also strongly encourage you to discuss the situation with the decision-making authorities of your association.
Addendum 1 Rule 1 (Medicine):
This time supplement is added to the principal visit and the transfer visit. It is payable in a private office, in-patient and out-patient clinic setting. The disciplines affected are allergy, dermatology, endocrinology, gastroenterology, geriatrics, public hygiene, microbiology, nephrology, neurology, pediatrics, physiatry, pulmonology, rheumatology, public health, and preventive medicine or occupational medicine.
This time supplement is added to the principal visit and the transfer visit. It is payable in a private office, in-patient and out-patient clinic setting.” The disciplines affected are allergy, dermatology, endocrinology, gastroenterology, geriatrics, Public Health, microbiology, nephrology, neurology, pediatrics, physiatry, pulmonology, rheumatology, public health, and preventive medicine or an occupational physician.
Rule 2.8 of Addendum 4 (Surgery):
This time supplement is in addition to the principal visit of a patient seen in a private office or in a designed room in an acute care facility. However, in obstetrics and gynaecology, this time supplement is also added to the principal visit of an inpatient or outpatient clinic. In ophthalmology, this time supplement is also added to the principal visit and for the follow-up visit of an inpatient or outpatient. The disciplines covered are : cardiovascular and thoracic surgery, orthopedic surgery, plastic surgery, neurosurgery, obstetrics and gynecology, ophthalmology, otolaryngology