Claims Disputes – The Role of Doctors Manitoba
Manitoba Health uses internal payment policies to guide its staff and streamline processes. However, the Physician’s Manual, which is like a contract between Doctors Manitoba and Manitoba Health, is the result of hundreds of negotiations and can lead to differences of interpretation.
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 and their billing staff should contact Doctors Manitoba for advice and assistance.
In these instances, Doctors Manitoba:
- Provide 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 introduction of New Fee Tariffs;
- Attends meetings to discuss unresolved issues involving claims; and
- Provides access to dispute resolution mechanisms.
April 8, 2021