How do I bill Quebec’s provincial insurance program?

How do I bill Quebec’s provincial insurance program?

Bill Quebec’s provincial health insurance program in 2 Steps:

  1. Go to Patient Profile\Reports & Labels and click on Custom Templates. Choose the template and click on the Custom Templates button once more.  
  2. Complete the form and mail to:
    Régie de l’assurance maladie du Québec
    Service de l’application des programmes (Q037)
    Case postale 6600
    Québec (Québec)
    G1K 7T3 
Step 1
Step 2

Detailed Explanation:

The ‘Out of Province Claim for Physician Services’ form is downloadable, as a PDF directly off Hype Medical’s Patient Profile section. The form is necessary to bill Quebec patients as they are not covered under OHIP as RMB claimants.

The ‘Out of Province Claim for Physician Services’ form downloads along with your patient’s demographics and, attending and referring doctor information.

The following services are excluded from RMB (but are not necessarily OHIP benefits) and should be billed directly to the non-resident patient (or to the non-resident’s home province/territory if prior approval has been granted by the home province/territory):

  • Surgery for alteration of appearance (cosmetic surgery)
  • Sex reassignment surgery
  • Surgery for reversal of sterilization
  • Routine periodic health examinations including routine eye examinations
  • In-vitro fertilization, artificial insemination
  • Lithotripsy for gall bladder stones
  • Treatment of port wine stains on other than the face or neck, regardless of the mode of treatment
  • Acupuncture, acupressure, transcutaneous electro-nerve stimulation (TENS),moxibustion, biofeedback, hypnotherapy
  • Services requested by a third party
  • Team conference(s)
  • Genetic screening and other genetic investigation, including DNA probes
  • Procedures still in the experimental/developmental phase
  • Anaesthetic services and surgical assistant services associated with all of the above
  • Services required by the Ministry of Community and Social Services and the Ministry of Attorney General or the Solicitor General
  • PET scans and Gamma Knife Radiosurgery
  • Telemedicine services
  • Services to persons covered by other agencies (e.g., Armed Forces, Workplace Safety and Insurance Board, Department of Veterans’ Affairs, Correctional Services of Canada [Federal penitentiaries])

*Originally published July 28, 2019

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