Elliott in talks with Ontario doctors over billing glitch
Ontario’s health minister has acknowledged that the province is having a problem paying its doctors for telephone consultations.
“We know there’s a problem right now with being paid,” Christine Elliott told reporters on Friday, adding that the government was in talks with the Ontario Medical Association.
“We know there are a number of physicians worried about keeping their offices open.”
Fee-for-service doctors ranging from family physicians to specialists are frustrated because they are not being paid for telephone consultations, as the province promised.
At issue are five billing codes that were added in mid-March after physical distancing measures were introduced, which made it difficult for physicians and patients to have face-to-face visits.
But the codes don’t work. The province said Thursday they would likely be activated early in May, meaning the doctors would be paid in mid-June.
Many doctors have discovered that patient volumes have dropped significantly at the same time they have not been paid for telephone consults. Their incomes have been slashed and they are grappling to pay for rent, staff, diagnostic equipment and other overhead costs. OMA president Dr. Sohail Gandhi says a fix to the billing problem is easy, but he’s not optimistic it will be solved quickly. The OMA has been in talks with the province for a month already, he said.
Some other provinces have introduced income stabilization measures to assist doctors, Gandhi said.
One example is an agreement in Newfoundland, where doctors are being paid 80 per cent of average billings on condition that they keep their clinics open and assist where needed in areas facing COVID -19 outbreaks.
Another possible solution is to allow doctors to bill using their regular consultation codes. The amounts of money are the same as for telephone consultations, Gandhi said.
Dr. Alykhan Abdulla, a Manotick physician, said colleagues had reported drops in income ranging from 25 per cent to 90 per cent. Some say they will be closing their clinics in the next week.
Both Gandhi and Abdulla are concerned that it will be hard to ramp up the primary health-care system again in a post-COVID world.
“It’s not going to be easy to turn it back on. It’s not a light switch,” said Abdulla, who is vice-chair of the OMA’s section of general and family practice, representing 14,000 family doctors.
“It’s not an issue of greed. It’s an issue of paying expenses. It’s about keeping people operational,” he said. “They’re looking at six to eight weeks to deal with it. That’s not good enough.”
The average family physician bills between $20,000 and $50,000 a month, and much of it goes to pay overhead, Abdulla said. For many, it will be hard to get lines of credit to cover the next few months.
“Everyone lives from month to month. There will be a payday. But we have to live.”