Providing care to patients from outside British Columbia is common—especially in border communities, urban centres, and travel-heavy regions. While these encounters are routine, out-of-province billing can introduce added complexity if workflows and requirements aren’t clearly understood.
OSCAR Pro supports BC clinics with tools designed to streamline reciprocal medical billing, Teleplan submissions, and error prevention. In this blog, we explore key considerations and workflows that help clinics manage out-of-province billing confidently, while ensuring claims are submitted accurately and on time.
Understanding Out-of-Province Billing in BC
British Columbia participates in Canada’s reciprocal billing agreement, allowing physicians to bill MSP directly for insured services provided to patients covered by other provincial health plans—with the exception of Quebec.
Unlike private billing scenarios, these claims are submitted through Teleplan, using the patient’s valid provincial health number. While the billing workflow in OSCAR Pro looks familiar, there are important details clinics should be aware of to avoid rejections or delays.
Registering Out-of-Province Patients Correctly
Accurate patient registration is the foundation of successful out-of-province billing.
When adding an out-of-province patient in OSCAR Pro, clinics should ensure:
- The health card number contains no spaces, letters, or special characters.
- The correct province of coverage is selected.
- A patient address is entered (either in BC or their home province).
Failing to include an address will result in rejected claims. Clinics should also verify that the patient’s health card has not expired, as some provinces issue cards with expiry dates. Many practices find it helpful to scan a copy of the card into the patient’s eChart for reference.
If a patient cannot provide a valid health card, clinics may bill privately and allow the patient to seek reimbursement from their home province.
Creating Out-of-Province Invoices in OSCAR Pro
One of the benefits of OSCAR Pro is that out-of-province billing does not require a separate invoice type.
Invoices are created in the same way as standard MSP claims. There is no special flag to indicate that a patient is from another province—responsibility rests with the physician or billing agent to:
- Select the appropriate service codes.
- Confirm the service is covered under reciprocal billing agreements.
For example, clinics billing under the Longitudinal Family Physician (LFP) payment model should note that LFP service codes are not eligible for out-of-province patients. In these cases, the appropriate fee-for-service (FFS) codes must be used instead.
For more information on out-of-province billing, read our knowledge base article or watch our step by step video.
Simulating & Generating Teleplan Claim Files
Before submitting claims to MSP, clinics should always simulate their Teleplan file. This step helps identify basic formatting issues and reduces the risk of rejected claims.
Why simulation matters:
- Errors are clearly flagged and can often be corrected before submission.
- Clinics can review invoices directly from the simulation report.
- Invoice statuses remain editable until the claim file is generated.
One important exception to note:
For out-of-province patients, OSCAR Pro cannot verify eligibility across provincial systems. As a result, simulations may display an error related to the patient’s PHN. This is expected and can be safely ignored for out-of-province claims.
Once reviewed, clinics can generate the Teleplan claim file. After generation:
- Invoices move to SUB (Submitted) status.
- Files are sent to MSP in sequence.
- Claims can no longer be undone locally.
If an invoice in SUB status needs to be cancelled, clinics must either wait for MSP processing or contact MSP directly to request that the claim be “zapped.”
A detailed walkthrough of simulating, generating, sending, and reviewing Teleplan files—including handling submitted claims is available here.
Best Practices for Cross-Province Billing in BC
To keep out-of-province billing running smoothly, BC clinics should:
- Verify health card details directly from patient ID.
- Always include a patient address in the Master Record.
- Understand which services are excluded from reciprocal agreements.
- Simulate Teleplan files regularly to catch issues early.
- Submit claims frequently to stay aligned with MSP processing cycles.
For questions about coverage rules or what is billable, clinics should contact MSP directly, as provincial billing policies ultimately determine eligibility.
Learn More in the OSCAR Pro Support Portal
Out-of-province care is an important part of delivering accessible healthcare in BC. With the right setup and a clear understanding of reciprocal billing rules, clinics can manage these claims efficiently within their existing workflows.
OSCAR Pro provides the tools and guidance needed to support accurate submissions—helping clinics focus less on administrative complexity and more on patient care. Visit the OSCAR Pro Support Portal to explore full resources on MSP billing, reciprocal (RMB) billing, IFH billing, and claim submission workflows—and empower your billing team with the tools they need to succeed.