Providing a medical report or other medical information about a patient to an insurance company is an uninsured service for which you may bill directly. 

But do you bill the patient or the insurance company? 

We recommend that you take the following steps

Requests from Insurance Company

If the request comes directly from the insurance company (provided the request includes an appropriate written patient authorization), inform the insurance company in writing:

1. That there will be a fee for the service;
2. What that fee will be; and
3. That before you prepare the medical report/​information, you require written confirmation that the insurance company will pay your fee promptly after delivery of the medical report/​information.

Requests from Patient

This applies in BOTH of the following cases:

1. The patient attends at your office and requests that a medical report/​information be provided to his/​her insurance company.
   
2. The insurance company sends you an authorization, signed by the patient, to provide the insurance company with a medical report/​information, and the authorization states the patient is to be responsible for the costs of the service.

In either case, inform your patient (preferably in writing):

1. That there will be a fee for the service;
2. What that fee will be; and
3. That before you prepare the medical report/​information you require written confirmation that the patient will pay your fee promptly after delivery of the medical report/​information to the insurance company.

Suppose your patient takes issue with whether they (as opposed to the insurance company) should be responsible for the fee’s payment. In that case, advise your patient that this is a matter to be worked out directly between the patient and the insurance company. Ask your patient to contact you after discussing the matter with their insurance company to advise you of the outcome. After that, follow the appropriate steps set out above. 

Please contact us if you have questions about your fee for the provision of a medical report/​information to an insurance company. 

Questions?

Andrew Swan
aswan@​doctorsmanitoba.​ca
204−985−5860