Ontario Ministry of Health and Long-Term Care by 490Z1n

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									                     Ontario Ministry of Health and Long-Term Care
                         Health Care Programs, North Region
                              Underserviced Area Program


                      Visiting Specialist Clinic Program Guidelines


OBJECTIVE

To provide specialty service on an outreach basis in approved communities in Northern
Ontario where the population base cannot support a full-time physician.

DEFINITION

A program where a specialist provides one- to three-day clinics in a community in Northern
Ontario more than 40 kilometers from the nearest physician in that specialty.

Northern Ontario is defined as the territorial districts of Algoma, Cochrane, Kenora,
Manitoulin, Muskoka, Nipissing, Parry Sound, Rainy River, Sudbury, Thunder Bay and
Timiskaming.

A community designated as underserviced in a specialty is not eligible to receive outreach
clinics in that specialty through the Visiting Specialist Clinic Program.

ELIGIBILITY TO PROVIDE APPROVED CLINIC SERVICES

To be eligible to provide clinic services, the physician must:

a) Arrange to provide clinic services in an eligible community
b) Hold a valid Certificate of Registration from the College of Physicians and Surgeons of
   Ontario
c) Hold a certification number from The Royal College of Physicians and Surgeons of Canada
d) Hold a Canadian Medical Protective Association membership number
e) Hold an OHIP billing number and billing privileges
f) Provide a Social Insurance Number

REMUNERATION

To be eligible for payment, the physician must provide a minimum of six (6) hours of clinical
service per day.

The physician may choose to bill fee-for-service to OHIP or claim a daily stipend of $590.
Physicians are encouraged to bill fee-for-service rather than stipend on days that at least
$590 can be billed to OHIP.
                           Visiting Specialist Clinic Program Guidelines
                Health Care Programs, North Region, Underserviced Area Program
                                         October 1, 2001
A physician may either bill fee-for-service or stipend on any approved clinic day, but claiming
both types of payment for the same clinic day is prohibited. Note that this does not apply if
a physician has provided office or on call services in his/her home community prior to
providing service at the clinic site.

Honorarium - $300 per day

A physician is allowed a $300 honorarium per approved day (minimum six hours of clinical
service). Only one honorarium may be claimed each day and it cannot be pro-rated.

The physician may claim a $300 per day honorarium on days when travel is necessary within
Ontario, to a maximum of four days. The physician may claim an honorarium for any travel
day, regardless of whether s/he has provided office or on call services in his/her home
community on the day of travel to the clinic site. Only one honorarium may be claimed each
day and it cannot be pro-rated.

Fee-For-Service

The physician bills fee-for-service per the OHIP fee schedule. Physicians are expected to bill
fee-for-service rather than stipend on days that at least $590 can be billed to OHIP.

If the physician is concerned that billing fee-for-service during clinics periods may have an
adverse affect on his/her personal billing threshold, s/he is encourage to contact the UAP to
discuss whether a UAP billing number will address those concerns.

Stipend - $590 per day

The physician is paid a stipend only for days worked (minimum of six hours of clinical
service).


Third Party Billing

Medical services and the paperwork for certain items are not covered by OHIP and can be
billed directly to the patient. For further information about third party billing, please contact
your local OHIP office.

EXPENSES

The physician must have written approval prior to providing a clinic.

Accounts (statements of expenses, billing forms, etc.) and inquiries must be received within
90 days of the date of service to be eligible for payment. Claims received after 90 days will
not be paid.

                           Visiting Specialist Clinic Program Guidelines
                Health Care Programs, North Region, Underserviced Area Program
                                         October 1, 2001
Physicians living outside of Ontario will be reimbursed for travel from within Ontario or the
nearest point of entry (Montreal or Winnipeg). Reimbursement of travel expenses within
Ontario will be calculated on the least expensive mode of travel (economy airfare or use of a
personal vehicle).

Airfare is based on economy class. The receipt is the last page(s) of the airline ticket or a
copy of the electronic ticket.

Use of a personal vehicle is paid at 30.5¢ per kilometer.

Rental of a compact car and gasoline (with receipts).

Single occupant accommodations.

Meals to a maximum of $31.75 per day.

NON-ALLOWABLE EXPENSES

   Travel outside of Ontario (to and from the province)
   CMPA insurance (required to join the program)
   Costs to obtain a Certificate of Registration to practice medicine in Ontario
   Personal long distance telephone charges


For more information, please call (705) 564-7280, fax (705) 564-7493 or write to:

                            Ministry of Health and Long-Term Care
                            Health Care Programs, North Region
                            Underserviced Area Program
                            159 Cedar Street, Suite 406
                            Sudbury ON P3E 6A5




                           Visiting Specialist Clinic Program Guidelines
                Health Care Programs, North Region, Underserviced Area Program
                                         October 1, 2001

								
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