Provisional Tariffs

Rule of Application 56

Manitoba Health and Doctors Manitoba regularly agree to establish new services as provisional tariffs.  A provisional tariff is denoted in the Physician’s Manual by a tilde (~) preceding the tariff number.  All claims for provisional tariffs must be submitted in accordance with Rule of Application 56 that states:

A provisional tariff means that the particular service is under evaluation for a period of time not to exceed eighteen (18) months from its effective date. Payment for claims shall be made in accordance with the same Rules of Application that apply to permanent tariffs. In addition to the normal requirements for submitting a claim as set out in Claims Submission and Payment Procedure-Part III Instructions for Completion of Claim Forms, for surgical procedures an operative report and for non-surgical services a descriptive report, including the length of time for the procedure or service, must be submitted with any claim for a provisional tariff. The reports may be reviewed by Manitoba Health and Doctors Manitoba as part of the evaluation of the provisional tariff. At the end of the evaluation period the tariff shall either become a permanent tariff or amended/deleted upon the agreement of Manitoba Health and Doctors Manitoba.

Billing Notes

  • If you intend on providing a service claimable under a provisional tariff number, it is recommended that you or your billing staff contact the Manitoba Health Claims Unit  (204-786-7269) directly to confirm an efficient reporting mechanism that will satisfy Manitoba Health’s information requirements.
  • All other Rules of Application apply to provisional tariffs in the same manner as they would apply if the tariff was permanent e.g., multiple surgical services Rules, eligibility for After Hours Premiums etc.
  • Claims for provisional tariffs will be paid in accordance with the Rules of Application at the rate listed in the Physician’s Manual.  No retroactive adjustments (up or down) will be made for services rendered during the evaluation period.

Questions?

Ian Foster
ifoster@docsmb.org
(204) 985-5854

 

Updated: November 2016