Audit: A year of reflection

Issue: BCMJ, vol. 59 , No. 1 , January February 2017 , Pages 47 Billing Tips

As my term as chair of the Patterns of Practice Committee comes to an end, I might reflect on the committee’s work over the past 3 or so years.


As my term as chair of the Patterns of Practice Committee comes to an end, I might reflect on the committee’s work over the past 3 or so years.

We have, we feel, established a respectful, collaborative relationship with the Billing Integrity Program, the Audit and Inspection Committee, and the Medical Services Commission, and we are again equal members of the Audit Working Group. Although the Billing Integrity Program and the Audit and Inspection Committee have a fiduciary duty to address improper billing practices, the emphasis is also on education, not only on recovery. To this end we have been working on ways to educate and support physicians to bill in an ethical, responsible way, while at the same time receiving what is their due for work done.

We initiated the Billing Tips articles and have developed an in-person presentation that addresses the most common billing errors while also explaining the audit process. We have also begun to hold joint presentations with the Society of General Practitioners.

The Billing Integrity Program now informs us of trends in inadvertent misbilling within a specialty so that we may meet with the section head to discuss how to correct those trends. We have also begun to work with the chair of the Medical Services Commission and the Guidelines and Protocols Committee to address waste in our system with respect to laboratory, X-ray, and prescribing costs.

From my perspective, the most important advice for physicians is this: Seek billing advice from those who are sanctioned to give that advice (a billing advisor at Doctors of BC, the Society of General Practitioners, or the General Practice Services Committee), not from self-proclaimed billing experts. If you think there is a disparity in the fees being paid for work done, direct your concerns to the Society of General Practitioners or Specialists of BC, rather than manipulating fee codes. Your concerns will be addressed by the Tariff Committee.

I would like to thank Ms Juanita Grant and Mr Rob Hulyk for their tireless work in achieving our goals, and the other members of the committee for their support. I wish the new chair success with taking the committee to the next level.
—Keith J. White, MD
Chair, Patterns of Practice Committee

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This article is the opinion of the Patterns of Practice Committee and has not been peer reviewed by the BCMJ Editorial Board. For further information contact Juanita Grant, audit and billing advisor, Physician and External Affairs, at 604 638-2829 or jgrant@doctorsofbc.ca.

Keith J. White, MD. Audit: A year of reflection. BCMJ, Vol. 59, No. 1, January, February, 2017, Page(s) 47 - Billing Tips.



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rplunkettboyle say: reply

My father, a GP before medicare and after (i.e., 1954 to 1992), in Canada, gave me the best advice for integrity in billing that I use to this day... "NEVER submit a bill to the MHSC that you wouldn't submit to your patient." He worked in Manitoba--MHSC. Following that rule, after perusing the preamble about what is covered and what is not, is the golden rule that will prevent any audit, etc., and allow the doctor to sleep well at night.

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