Assessment of Claims: Questions
Do you have a question about how Manitoba Health has assessed a fee-for-service claim? If so, Doctors Manitoba suggests that you follow these steps in sequence.
- 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. Found the error? Resubmit the claim with the correct information.
- Review the relevant sections of your Physician’s Manual together with any materials from Doctors Manitoba that relate to the subject of your inquiry.
Doctors Manitoba recommends locating the subject topic in the Remuneration section of our website.
- Ask Manitoba Health for an explanation of the claim’s assessment.
Locate a comprehensive list of Manitoba Health contacts in the Physician’s Manual and on-line here.
- Not satisfied with Manitoba Health’s explanation?
Contact Doctors Manitoba staff to ask their view of 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.
Regarding disagreement with an assessment, Doctors Manitoba staff will usually first contact Manitoba Health and attempt to resolve the matter on an informal basis.
Staff will advise you of other options should the issue not be resolved informally.
April 8, 2021