What is H010A?
H010A is not a regular patient-specific fee-for-service code.
H010A is the service code used to claim Ontario's daily anaesthesia stipend. For H010A, the Number of Services represents the physician's eligible stipend hours for a particular service date, subject to the Ministry's anaesthesia stipend rules.
Eligible time is generally accumulated during scheduled weekday hours Monday to Friday, from 7:00 a.m. to 5:00 p.m.
The Ministry's anaesthesia stipend rules determine which activities and periods of time may or may not be included when calculating the eligible hours for each service date.
Refer to:
- OHIP INFOBulletin 260311 – Physician Services Agreement – Targeted Funding, Anaesthesia Stipend for eligibility and qualifying-time rules.
- OHIP INFOBulletin 260802 – Physician Services Agreement – Update on Anaesthesia Stipend for the H010A service code and claims-submission requirements.
If you use QuickClaim to submit for more then one physician in a certain group number your H010A claims should be created and submitted one physician at a time:
Three Important Requirements for QuickClaim Users
Before billing H010A, keep these three requirements in mind:
1. H010A must be billed using a doctor profile affiliated with the applicable anaesthesia stipend group number.
The physician's H010A claims must be created using a QuickClaim doctor profile that is specifically affiliated with the appropriate anaesthesia stipend group number.
For QuickClaim users, this means creating a separate doctor profile specifically for H010A stipend billing.
2. The physician does not need to be added as a Designee to the stipend group's OPS BPS Secure account.
Although the H010A doctor profile is affiliated with the applicable anaesthesia stipend group number, the physician does not have to be added as a Designee to the OPS BPS Secure account associated with that group.
3. H010A claims must be submitted through the physician's own solo-provider MCEDT account with the new doctor profile that is under the applicable anaesthesia stipend group number.
The physician's H010A claims must be:
Created using the doctor profile affiliated with the applicable anaesthesia stipend group number; and
Submitted to OHIP using the individual physician's own solo-provider MCEDT account with the new doctor profile that is under the applicable anaesthesia stipend group number.
That is why if you use QuickClaim to submit for more then one physician in a certain group number your H010A claims should be created and submitted one physician at a time.
If H010A claims for two or more physicians are created together, QuickClaim may include those physicians' claims in the same submission batch. That batch would then be submitted under the group's MCEDT account, rather than through each physician's individual solo-provider MCEDT account.
Recommended workflow: Complete the H010A claims for one physician, submit that physician's batch through their solo-provider MCEDT account, and only then proceed to the next physician.
One-Time QuickClaim Setup
Step 1 — Create a Stipend Physician Profile
- Click Providers on the QuickClaim main menu.
- Click on the → Enter New tab
- Enter the physician information using the same values as the physician's regular Providers setup in the Existing tab.
- In the Group Number field, enter the physician's applicable anaesthesia stipend group number.
- Click Save.
You will now have an additional QuickClaim profile for the physician:
- the physician's regular profile used for normal OHIP billing; and
- a stipend physician profile, containing the anaesthesia stipend group number, used for H010A billing.
Step 2 — Add H010A to the QuickClaim Service Code Database
- Click Codes on the QuickClaim main menu.
- Click Add New.
- Enter H010 — not H010A — in the Service Code field.
- Click Save.
H010A can now be entered when preparing the stipend claim.
How Many H010A Services Do I Bill?
Before creating the H010A claim, determine the physician's total eligible stipend time for that service date according to the Ministry's anaesthesia stipend rules.
Do not round each individual period of eligible time separately.
Instead:
- Identify all eligible stipend time for the service date.
- Add the eligible periods together.
- Determine the physician's total eligible time for the day.
- Round the daily total according to the Ministry's stipend rules.
- Use the resulting stipend tier/hours as the # of Services on the H010A claim.
Example
A physician has two periods of eligible stipend time during the same service date:
Add the time together:
2.6 + 3.7 = 6.3 eligible hours
The daily total is then rounded according to the stipend rules.
In this example, 6.3 hours results in Tier 6, so the H010A claim is entered with:
H010A × 6 # of Services, or 6 hours.
Do not round 2.6 hours and 3.7 hours separately and then add the rounded amounts together. The eligible time is accumulated first and the resulting daily total determines the H010A tier.
Billing H010A in QuickClaim
Step 1 — Start the Claim
Click the New claim icon.
Select:
Step 2 — Enter the H010A Claim
Enter:
- Service Code: H010A
- Number of Services: the applicable H010A stipend tier for that service date
- Service Date: the date on which the eligible stipend time occurred
For example, if the physician's eligible daily time results in Tier 6, enter:
H010A — Number of Services: 6
A single QuickClaim claim form can contain multiple H010A service lines, with each line representing a different service date.
This can make it convenient to enter several days of stipend billing on one claim.
Step 3 — Save the Claim
Because H010A is not patient-specific, normal patient demographics are not required for the stipend service.
- Click Save Claim.
- QuickClaim will display a warning because patient information is missing.
- Click Save Anyways to save the H010A claim.
Submitting H010A Through MCEDT
This step is especially important for billing agents or QuickClaim users who bill for more than one physician within the same stipend group.
Prepare and submit H010A claims for only one stipend physician profile at a time.
For example:
Physician A
Prepare Physician A's H010A claims → select Physician A's stipend physician profile → submit the claims under Physician A's anaesthesia stipend group number profile.
Then proceed to:
Physician B
Prepare Physician B's H010A claims → select Physician B's stipend physician profile → submit the claims under Physician B's anaesthesia stipend group number profile.
Do not combine stipend claims for several physicians into a single submission.
Keeping each physician's H010A claims separate helps ensure that only that physician's claims containing the stipend group number are submitted under the correct physician's anaesthesia stipend group number profile.
QuickClaim Billing Tip: Create a "Stipend" Patient
H010A is not patient-specific, so QuickClaim can save the claim without normal patient demographics.
If you simply save each H010A claim without patient information, QuickClaim will create an empty patient record for each non-patient-specific claim.
That is the simplest way to bill H010A and it will work.
However, over time it can create unnecessary empty patient records.
A More Efficient Approach
When creating your first stipend claim, distinguish the empty patient profile with a single entry, enter a fictitious last name such as:
Last Name: Stipend
QuickClaim will create a patient record called Stipend.
For future H010A claims, simply search for and select the same Stipend patient record.
This allows you to keep your non-patient-specific H010A claims under one easily identifiable patient record, making it much easier to find and review your historical anaesthesia stipend billing.
H010A QuickClaim Workflow at a Glance
Set Up Once
Create a duplicate physician profile
→ Add the anaesthesia stipend group number
Add H010 to the QuickClaim service-code database
Calculate Each Day
Identify eligible stipend activity
→ Total all eligible time for the service date
→ Apply the Ministry's daily rounding/tier rules
→ Determine the H010A Number of Services
Create the Claim
Click on the New icon in the Claims column of the QuickClaim main menu
Choose the stipend physician profile in the Doctor field
Optional: Enter a fictitious last name in the Patient Last Name field
Enter ON in the Province Code field
→ Enter H010A in the service code field
→ Enter the applicable Number of Services
→ Enter the Service Date
→ Save the claim
Submit
Prepare one physician's stipend claims at a time
→ Submit using that physician's new stipend physician profile