Patient Care Family Conference — Tariff 8473
The key components of Tariff 8473 Patient Care Family Conference are as follows:
- The conference must relate to the care and treatment of a patient; but
- There is no specific requirement as to the condition of the patient nor the subject matter of the conference. The tariff description provides some examples of what conditions a patient may have and what may be discussed during the conference.
Discussions about the condition and care of a patient with one or more of the following conditions:
- serious and complex problems
- a catastrophic or terminal illness
- developmental and multiple handicap disorders
- chronic pain
- the assessment of the need of care from other providers and/or community agencies.
Note: These are examples only. The patient who is the subject of a Patient Care Family Conference may have a condition other than those listed above, and the subject matter of the conference may be something other than that listed above. Also note:
- The conference does not have to formally scheduled
- The conference may immediately precede or follow a patient visit (but claim cannot be made for a conference that takes place during the same time frame as the patient visit).
- The patient may or may not be present at the conference.
- A maximum of one hour may be claimed per conference.
- A maximum of twelve 15 minute sessions per patient per year may be claimed. Additional conferences may be claimed By Report.
- The rate is payable for the first full 15-minute period of the conference or for each additional 15-minute period or major portion thereof.
- The tariff may be claimed by all blocs of practice, except of Psychiatry and Physical Medicine
- The conference must be documented in the patient chart in accordance with the requirements of the College of Physicians and Surgeons (and Manitoba health has the right to request a copy of this entry in the patient chart to support the claim).
Some physicians who have had their claims under Tariff 8473 audited by Manitoba Health have been led to believe that they had failed to comply with certain “requirements” of the tariff, while some those “requirements” do not exist. In particular:
- It is a requirement that the start/stop times of the patient conference be noted in the patient chart. Where a conference immediately precedes or follows a patient visit, note the start/stop times of both the patient visit and the conference in the patient chart so that if their claims under this tariff are audited by Manitoba Health, it will be easier to establish that the conference took place at a separate time than the visit.
- It is not a requirement of this tariff that “exceptional circumstances” must exist to support the claim.
- It is not a requirement of this tariff that the condition of the patient discussed during the conference must be “serious and complex” or “more than routine”.
Physicians who have had claims under Tariff 8473 rejected by Manitoba Health should contact Doctors Manitoba for advice and assistance, including, where appropriate, the filing of a grievance.