If you’re treating a patient who holds health coverage from another Canadian province, British Columbia’s Medical Services Plan (MSP) requires a specific registration and billing process to make sure your claim goes through — and that you actually get paid. Here’s a step-by-step walkthrough of how to register an out-of-province patient correctly and what to expect when billing.
Out-of-Province Registration and Billing
Step 1: Enter the Health Insurance Number Correctly
Whether you’re creating a new patient demographic or editing an existing one, the health insurance number needs to be entered as numbers only — no dashes, no spaces, and no letters. This matters because some provinces format their health card numbers differently. For example, Ontario health cards typically include a two-letter version code at the end, and that version code should not be entered into the health insurance number field.
Step 2: Select the Correct Province in the Health Insurance Type Dropdown
Along with the number itself, make sure the health insurance type dropdown is set to the patient’s actual home province — not BC. This tells the system the patient is covered under a different provincial plan and is essential for accurate reciprocal billing.
Step 3: Always Add a Patient Address
One of the most important — and most commonly missed — steps for out-of-province patients is entering an address in their contact information. This field cannot be left blank. The address can be either:
- Where the patient is currently staying or living in BC, or
- Their permanent address out of province
Either option works but leaving this field empty can cause issues with billing submission.
What to Expect When Billing Out-of-Province Patients
When creating an invoice for a physician, there’s no visual flag on the billing screen indicating the patient is from out of province. The invoice screen looks the same as any other billing entry — so it’s easy to forget which patients require this extra care.
You Will Likely See a Red Band Error During Simulation
When you run your billing simulation prior to submitting your file to MSP, you should expect to see a red band error related to the insurance number or PHN (Personal Health Number). This happens because MSP cannot verify eligibility for patients from a different province through the standard validation process.
Important: This is one of the few situations where it’s acceptable to submit a claim despite a red band error — as long as:
- The billing code falls under the reciprocal billing agreement, and
- The patient has active medical coverage in their home province
If you want extra assurance before submitting, you can contact the patient’s home province Ministry of Health directly to confirm their coverage is active.
Quick Recap: BC Out-of-Province Registration & Billing Checklist
- Enter the health insurance number as digits only (no letters, dashes, or spaces)
- Remove any version codes (e.g., Ontario’s two-letter suffix)
- Select the correct home province in the health insurance type dropdown
- Add a patient address — BC or out-of-province, but never blank
- Expect a red band error during billing simulation for out-of-province PHNs
- Confirm the billed code falls under the reciprocal agreement before submitting
- Contact the home province’s Ministry of Health if you need to verify active coverage
Frequently Asked Questions
Why does my billing simulation show an error for out-of-province patients?
MSP cannot check eligibility for patients from a different province through the system, so a red band error related to the insurance number or PHN is expected and normal in these cases.
Is it safe to submit a claim with a red band error?
Yes, in this specific situation. As long as the billing code falls under the reciprocal agreement and the patient has active coverage in their home province, submitting with this particular red band error is acceptable.
Where do I go with questions about the reciprocal billing agreement?
Reach out to the Ministry of Health / MSP directly for questions specific to reciprocal billing rules for BC.
Does the billing screen show that a patient is from out of province?
No. There is no flag or indicator on the billing screen itself — the only signal you’ll typically see is the red band error during submission simulation.
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