While we work to implement automation and more robust reporting on your new time codes, FHO providers in Ontario can use this temporary report template to assist with the finicky math after billing.
You can find the full details of the changes published by the OMA here.
What are these new codes?
We recommend reading the full explanation if you aren't familiar, but in brief:
- There are four new billing codes which can be billed each day to represent time spent on patient care.
- These codes are billed in 15 minute time units, similar to CME.
- These codes are billed using the 'Bonus Codes' billing type, similar to CME. They can be assigned to any patient, but we recommend making a new one for each provider.
- The Q310 and Q311 codes are for direct patient care (seeing patients, talking to them remotely, etc.)
- The Q312 and Q313 codes are for indirect care (admin work, reviewing reports, charting after visits, etc.)
What are the rules?
These codes come with several restrictions and limitations, but the most important ones to know in the short term (and the ones this report will help you balance) are:
- Each day can have no more than 14 total hours of these codes billed (56 total units.)
- No less than 75% of the codes billed per month can be direct care (Q310+Q311)
- No more than 240 hours per 28 day month (prorated for longer months) can be billed in total. This works out to ~257 hours for April and ~266 hours for May.
- These billing periods go from the 1st to the last day of the month, not from the 18th to the 18th like other billing.
What is this report for?
OMD has notified us that there will be no mechanism in place as of April 1st to prevent providers from billing outside of these limitations, and that any invoice will be honoured, but any overbilling or imbalanced billing will result in a clawback and an audit at a later date.
As such, we know it's critical (and nerve wracking) for your clinic to make sure their billing is balanced for these new codes.
We've produced a report which will assist you in working out how to manage your billing before submission and ensure you maximize your billings without causing headaches later on.
How do I access this report?
Download the FHOPlus.xml report file
Then navigate to your Admin > Reports (1) > Report by Template (2) tool and click 'Add Template' (3.) When prompted, choose the downloaded file and click 'upload & add'.
You'll see a new option under 'Select a Template' called 'FHO+ Time Code Rollover Calculation'. If you have trouble with this step, please contact our support team via help@oscarprodesk.ca and they will be happy to assist you.
From now on, you can access this report from the Report by Template menu at any time.
How do I use this report?
Select the report and set the date range from the first of the month to today, then pick yourself from the list of providers. Finally click 'Run Query.'
The system will scan all your invoices for the four new timecodes and arrange them in a table that you can review, with a few helpful warnings if your ratios are off.
The report will break down each days invoice(s) for the various timecodes and few key pieces of information to help you manage until we implement a more robust report in the next few weeks.
- If you go over the daily cap of 14 total hours (56 time units) a warning will appear for that day. You must remove some of the codes for this day (generally from Q312 or Q313.)
- A percentage will display showing the balance of direct vs indirect codes billed in the period. Remember, you must bill at most 25% of your time as indirect care. If this number is higher, you have to pump the brakes on your indirect care codes until the balance is restored.
- The monthly cap is prorated based on a 28 day month, so we've done the math for you here showing both your current usage and the available cap for the month.
What's next?
We're working on a brand new report tool which will do all the calculation above, but with some additional information and tracking to help make things even smoother.
More importantly, this tool will automatically skim your activity logs in Oscar Pro and determine (as an estimate) what volumes of which codes you should bill, removing the need for manual tracking and avoiding the headache of tweaking your percentages.
We want to enable you to maximize your hourly billing while minimizing the hours you spend dealing with it.
We'll let you know as soon as this new report is available with a notification in your email as well as in the EMR.
As always, if you have any concerns or you have any ideas on how we can better help you, please let us know via our support team at help@oscarprodesk.ca.