Assessment of Claims: Questions

Do you have a question about how a fee-for-service claim has been assessed by Manitoba Health?

If so, Doctors Manitoba suggests that you follow these steps in sequence

  1. Review the Explanation of Benefits (EOB) code on your remittance advice.  In many instances the inclusion of additional information or remarks will be sufficient for your claim to be processed.  Simply resubmit the claim with the correct information.
  2. Next review the relevant sections of your Physician’s Manual together with any materials from Doctors Manitoba that relate to the subject of your inquiry. To assist you, we recommend you search for your subject topic in the “Billing” section of our website.
  3. Ask Manitoba Health why the claim has been assessed as it has.
    (NOTE: The list of Manitoba Health contacts  and telephone numbers is included in the Physician’s Manual and available on-line here.
  4. If you are not satisfied with Manitoba Health’s explanation, contact Doctors Manitoba and ask it’s view of  with Manitoba Health’s assessment of the claim*.

*To facilitate this review Doctors Manitoba staff will request a copy of your remittance advice showing what you claimed and what was paid by Manitoba Health.

Where there is a disagreement with the assessment, Doctors Manitoba staff will usually first contact Manitoba Health and attempt to resolve the matter on an informal basis.

If the matter cannot be resolved informally, staff will advise you of other options.

Who do you contact at Doctors Manitoba

Update: November 2016