The Joint Medical Professional Review Committee (JMPRC) is a physician peer-review committee that reviews the billing aspect of medical practice of fee-for-service physicians in Saskatchewan. The JMPRC is made up of physicians appointed by the Saskatchewan Medical Association (SMA), the Ministry of Health, and the College of Physicians and Surgeons of Saskatchewan (CPSS). Occasionally, there may be an additional temporary member appointed in situations where specific expertise is required.
The JMPRC has the authority to order recovery of a portion of a physician’s billings that were paid by Medical Services Branch.
The JMPRC may also refer physicians to the CPSS. Most referrals are based upon JMPRC concerns that there is potential misconduct pursuant to The Medical Profession Act, 1981, or that there may have been substandard patient care.
Physicians have to bill services to MSB in accordance with the Payment Schedule when they have entered into a Direct Payment Agreement with the Ministry of Health. Medical Services Branch Payment Schedules, Operations Bulletins, Billing Bulletins, Newsletters, and billing information sheets are available on the eHealth website.
- Remember - for a service to be an insured service, it must be medically required.
- Ensure that the service for which the account was submitted is the service that was rendered
- Document appropriately
- Establish appropriate practice routines
Remember, physicians are ultimately responsible and accountable for their billing regardless of who submits billing on their behalf.
Be aware that improper billing could lead to investigation of unprofessional conduct charges by the CPSS. Seek out billing resources when needed.