The Longitudinal Family Physician (LFP) payment model in British Columbia was designed to streamline the billing process and ensure that physicians are compensated for the time and care they provide. However, as with any billing system, there are common errors that can lead to delayed or rejected payments. Understanding these pitfalls can save time and ensure smooth payment.
Here are the top five billing errors under the LFP payment model and how to avoid them.
1. Billing LFP Codes on Out-of-Province Patients
One of the most common errors is billing LFP codes for patients who reside outside of British Columbia. The LFP model is specifically designed for BC residents, and the billing codes associated with it are not applicable to out-of-province patients. If a patient from another province requires care, it’s essential to use the correct fee-for-service codes or refer to the guidelines for out-of-province billing. This ensures that claims are processed correctly, and payment is not delayed.
2. Not Selecting “Duplicate” When Billing Multiple of the Same Time Codes
When billing for multiple services under the same time code on a single day, it’s crucial to select the “duplicate” option. Failing to do so can result in the claim being flagged as an error or rejected altogether. The billing system may interpret the repeated time codes as a duplicate entry rather than a legitimate service rendered multiple times.
3. LFP Locum Doctors Not Entering “Referred by Dr.” in Claim
When an LFP locum doctor provides care to a patient, it’s important to enter the name of the referring physician in the claim. This is a key requirement under the LFP payment model and ensures that the billing process acknowledges the continuity of care provided by different physicians. Neglecting to include this information can lead to claim rejection or delay.
4. Time Code Billing on Out-of-Province Patient
Similar to the first point, billing time codes for out-of-province patients under the LFP model is a common mistake. Time codes are specific to the LFP model and are intended for use with BC residents. Billing these codes for out-of-province patients can lead to rejections.
5. Billing Code 98022 with a Virtual Visit
Billing code 98022, which is used for in-person visits, should not be billed alongside a virtual visit. The LFP model distinguishes between in-person and virtual visits and using 98022 for a virtual encounter is a common mistake. This error can result in the entire claim being rejected or requiring resubmission with the correct codes.
Billing under the LFP model can be straightforward once you’re familiar with the rules and common errors. By being mindful of these top five billing mistakes, BC doctors can streamline their billing process, reduce claim rejections, and ensure timely payment for the services they provide. Keeping up to date with billing guidelines and regularly reviewing claims for accuracy will go a long way in avoiding these common pitfalls.
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