Doctors who don’t pay attention to their OMA agreements were probably very surprised to see a .5% reduction to their May 2013 RA OHIP payments.  Here are some items to note:

  • When did the discount start?   The discount began on all claims on or after April 1st, 2013.  Given that most May Remittance Advice reports included claims from about mid March to mid April, your May reduction was based on about 2 weeks worth of work.  June RAs, which should be released shortly, will include a full month of the reduction for most physicians.
  • When will it end?   This is not as clear-cut an answer.  The agreement, which can be found here, indicates that the reduction will be in effect for the duration of the current agreement, which ends on March 31st, 2014.  However, the reduction might be reduced or eliminated all together when they review it at the end of October, 2013, depending on how much savings is achieved.  If I were a betting man however…
  • Who does this reduction affect?   This .5% reduction is essentially ‘across the board’ and includes virtually all physicians, all types of OHIP billing, and all payment programs.
  • Are the individual codes reduced .5%?   No, the OHIP service codes themselves haven’t been reduced.  OHIP, instead, is simply deducting .5% of all OHIP related claims as a separate item on the RA.
  • What impact will it have on my billings?   Most MDs are excellent mathematicians in addition to being good doctors, but for those who aren’t:  If you normally bill $25K per month, your reduction will amount to $125 per month.

Of note, JCL will be basing our invoices on the amount OHIP actually paid you (like we always do).  So we will NOT be charging on the full amount, but rather on the reduced amount.