The holiday season brings changes to clinic schedules, increased patient demand, and unique billing considerations. For clinics using OSCAR Pro, this is a critical time to ensure billing workflows remain accurate, efficient, and fully aligned with MSP rules.
This MSP billing guide highlights the essential points BC physicians should keep in mind when billing over statutory holidays, adjusted clinic hours, and out-of-office periods.
Designated Holidays & Close-Off Dates
MSP publishes an annual list of designated holidays and claims close-off dates that affect when certain premiums apply and when claims must be submitted to make the next remittance cycle.
For the 2025 holiday season, BC statutory holidays include:
- December 25 – Christmas Day
- December 26 – Boxing Day
- December 29 – MSP Close-Off Date
- January 1 – New Year’s Day
These days may qualify for after-hours premiums or impact submission timing. Because close-off dates may shift around holidays, clinics should plan ahead to avoid delayed payments.
OSCAR Pro Tip:
Use internal billing reminders or appointment labels to flag designated holiday dates so billing staff can easily verify when premiums apply.
After-Hours & Out-of-Office Premiums
Holiday hours often fall outside regular clinic operations, which means after-hours premiums may apply if the service meets MSP requirements.
Key considerations:
- After-hours premiums correspond to the actual time the service was provided — not the clinic’s scheduled or adjusted holiday hours.
- Documentation should clearly indicate start and end times to support premium eligibility.
- Modified holiday hours (e.g., reduced operating hours) do not automatically qualify a visit for after-hours premiums. MSP relies on official after-hours definitions.
Clarifying Call-Out / Out-of-Office Premiums
If referring to call-out situations:
- Out-of-office hours premiums apply only when a service is initiated and rendered within MSP’s defined after-hours periods.
- These premiums apply to office visits only if the office is officially closed during that MSP-defined after-hours window — not simply because the clinic reduced its hours for the holidays.
OSCAR Pro Tip:
Ensure time-of-service fields are completed in each chart note. This helps billing staff quickly determine premium eligibility.
Scheduled vs. Unscheduled Care
MSP distinguishes scheduled from unscheduled services — a distinction that becomes especially important as clinics experience increased last-minute or urgent visits during the holidays.
A visit is considered scheduled if:
- The appointment was arranged in advance, even if on the same day.
A visit may be considered unscheduled if:
- The patient walks in or calls for immediate, urgent care.
Billing the wrong category can lead to claim refusals or premium ineligibility.
OSCAR Pro Tip:
Use clear visit-type indicators in your appointment workflow. Consider adding “Scheduled” or “Unscheduled/Urgent” in appointment notes, or apply tags within the Schedule module to make categorization accurate and consistent for billing.
LFP Model Considerations (MRP Tracking & Key Rebills)
For physicians billing under the Longitudinal Family Practice (LFP) model:
MRP Tracking
- LFP physicians must ensure at least 70% of encounters are with their own MRP patients.
- No more than 30% of visits can be with non-MRP patients.
- Adding an MRP tag in the chart or schedule can help maintain compliance.
Important LFP Rebilling Requirements
A reminder on upcoming annual requirements:
- LFP registration codes and the 98001 (Clinic-Based Services Transition Code) must be rebilled between January 1 – March 31, 2026.
- 14070 & 14071 (Portal Codes) should be billed at the beginning of each calendar year.
Claim Submission Timing Matters
Holiday close-off dates can shorten billing windows. Claims submitted after the cut off may fall into the next pay cycle, delaying reimbursement.
Best practices:
- Submit claims daily or same-day when possible.
- Avoid batching holiday-week claims for later – MSP may not process them in time.
- Encourage clinicians to complete billing immediately after the encounter to minimize backlogs.
OSCAR Pro Tip:
Enable Daily Claims Review in your OSCAR Pro workflow so billing staff can clean up claims before close-off dates.
Documentation Requirements
High holiday demand increases the important of clear documentation – especially when billing premiums, urgent care, or after-hours services.
Good documentation includes:
- The time of service
- The reason for urgency, if applicable
- Any clinical factors that justify after-hours or out-of-office premiums
- Whether care was scheduled or unscheduled
- Supporting details for prolonged or complex encounters
Through charting helps prevent refused claims, audits, or delayed payments.
Verify MSP Coverage Before Billing
The holiday season often brings:
- Students returning home
- Visitors staying temporarily
- Patients with expired or incorrect MSP coverage
Verifying coverage before billing reduces rejected claims.
OSCAR Pro Tip:
Check the patient’s MSP status in their Demographic Record and confirm eligibility during intake.
Holiday Clinic Workflow Tips
To keep billing smooth during the busiest time of year:
- Prepare a holiday coverage plan so physicians know who is responsible for urgent care blocks.
- Review fee codes and premiums with staff before the holiday period begins.
- Audit high-volume days (Dec 25-26, Jan 1) to ensure correct premium billing.
- Communicate any planned closures to your patients early to reduce unscheduled in-person visits.
Holiday billing in BC comes with unique consideration – from after-hours premiums to eligibility verification and documentation accuracy. By building a clear workflow and using OSCAR Pro’s scheduling, demographic, and billing tools, clinics can stay compliant with MSP requirements while ensuring accurate compensation.