PATIENT MANAGEMENT PROGRAM
Manitoba Health Services Commission
It is important to understand how Manitoba Health (MH) works in the province of Manitoba. The following
is a summary of the components of MH structure.
The Manitoba Government utilizes a method of billing fees for chiropractic services called TWO-TIER
BILLING. This means that in Manitoba, the Province will pay a PORTION of the fee for chiropractic services.
The REMAINDER of the fee is the direct responsibility of the patient.
The government agency under which fees are paid is the Manitoba Health Services Commission (MH). For
residents of Manitoba the rules are as follows:
Each patient is entitled to charge fees for chiropractic care to MH for up to 12 visits per year. The
billable amount is $11.00 per visit. The fiscal year runs from January to December. PMP will
automatically renew the visits for all MH patients every January.
Once the patient has reached the allowable amount, they are personally responsible for fees for
services, until the commencement of the new MH fiscal year.
MH will not pay for a claim if submitted more than 6 months after the treatment date.
If a claim is rejected by WCB or MPI you have 6 months from the service date to submit to MH.
General Information
MH has set down rules that apply to codes and fees for services rendered in a chiropractic office. All
treatments including examination are billed to MH with the code 8506 and fee of $11.00.
When entering patient data into PMP it is important to consider:
Correct fees are entered into the fee schedule in the program and are kept current with any changes.
MH fees are correctly entered in the program, and updated when necessary.
The Patient is listed as the correct type in the program. (ie. MH, MPI, WCB)
The Manitoba Health Number (6 digits) is correctly recorded in the patient file. (Make sure you look at
the card yourself when a new patient arrives. This procedure alone will help keep your accounts
receivable to a minimum.)
Surname & given name in the program are exactly the same as it appears on the Manitoba Health
Card.
Specific data is required for claims submission to MH. Missing data will result in a claim being rejected.
This may cause a delay in payment. The data required to submit a MH claim is as follows:
- Health number
- Service code for each visit
- Fee submitted for each visit
- Service date
- MH Diagnostic code
64
|
Manitoba Health Services Commission