Overview: Patient Care and Physician Billing
The College of Physicians and Surgeons of Saskatchewan is responsible to ensure the quality of care delivered by physicians to Saskatchewan patients by ensuring physicians abide by the Code of Ethics, Bylaws, Policies, Standards and Guidelines. At times, this may include aspects of billing procedures.
The Joint Medical Professional Review Committee (JMPRC) is established by section 49 of The Saskatchewan Medical Care Insurance Act and is governed by the Act and the Regulations under The Act. The JMPRC members are physicians, of which two are appointed by each of the Saskatchewan Medical Association, the College of Physicians and Surgeons of Saskatchewan, and the Ministry of Health. As per the Act, the Minister appoints a person as the Director of Professional Review. An individual from Medical Services serves in this role. The JMPRC reviews billing patterns of physicians referred by the Director of Professional Review. In cases where the JMPRC determine that improper billings were submitted to Medical Services and monies have been paid by the Minister inappropriately, they may order recovery from the physician.
Although quality is not a mandate of the JMPRC, if questions arise about the quality of the services provided during an audit, the JMPRC refers the matter to the CPSS. In recent months, many cases have been referred to the CPSS from the JMPRC.
It is imperative that physicians know what documentation is required, appropriate billing practices, the process for new insured services, and what occurs with the payment integrity audit. Please take the time to review the following JMPRC documentation sheets regarding the mandate of the JMPRC, its integrity audit processes, and information on billing and documentation.
To get started with the MSB, the College highly recommends for physicians to register at no charge for the MSB Online Billing Course.
Billing Bulletin No. 2 (April 1, 2019)
Billing Information Sheets
Documentation Requirements for the Purposes of Billing (03/19)
Joint Medical Professional Review Committee (JMPRC) (03/19)
Payment Integrity (Audit) (03/19)
Physician Billing Obligations Package (03/19)
Requesting Changes to the Payment Schedule (03/19)