Claims Disputes – The Role of Doctors Manitoba
Manitoba Health uses internal payment policies to guide its staff and streamline processes. An integral part of the Physicians Services Agreement, is the Physician’s Manual is a contract between Doctors Manitoba and Manitoba Health. Matters of appropriate interpretation of the Physician’s Manual should be raised to Doctors Manitoba for consideration.
Manitoba Health’s internal payment policies may not always reflect Doctors Manitoba’s view of how to apply a particular tariff or rule. Consequently, it can be challenging to resolve some payment disputes through direct interaction between Manitoba Health and a physician and their billing staff.
When these disputes arise, physicians should contact Doctors Manitoba for advice and assistance.
In these instances, Doctors Manitoba:
- Provides advice to physicians and their staff regarding specific billing matters;
- Represents physicians in discussions with Manitoba Health regarding payment;
- Negotiates changes to the Physician’s Manual to clarify payment of claims;
- Applies for the establishment of New Fee Tariffs;
- Attends meetings to discuss unresolved issues involving claims; and
- Provides access to dispute resolution mechanisms.