February 10, 2023

Updated LFP Payment Schedule available

The purpose of this newsletter is to provide the latest updates on the implementation of the Longitudinal Family Physician (LFP) Payment Model. We are continuing to listen to your feedback, and are working and meeting regularly with the provincial government to address your concerns. Below is updated information. To submit questions or feedback on the payment model, please email LFP.Billing@doctorsofbc.ca.

Only 10 days ago, a new payment model for longitudinal family physicians was launched in British Columbia. As of this morning, more than 1,500 physicians have registered for the payment model. We are working hard to support physicians with this transition while continuing to advocate for other payment models and needed solutions.

Updated LFP Payment Schedule available

An updated LFP Payment Schedule is now available with some important changes based on your feedback. The major changes have been identified in red text within the updated LFP Payment Schedule, dated February 2. We are continuing to work on addressing other questions and clarifications.

Notable changes in the updated document include:

Required Services (p. 2): You will have a period of four months after enrolment to build up to the minimum required panel size of 250 active patients.
How to Claim for Time Codes (p. 10):
- Time Codes can be submitted using the personal health number (PHN) and demographic information of the first or last patient for whom Direct Patient Care or Indirect Patient Care is provided on that day.
- When Time Codes are submitted on a day when only Clinical Administration Time is billed, use the information of the last patient for whom Direct Patient Care or Indirect Patient Care was provided.
Patient Interaction Code 98022 (p. 14): The wording has been updated to indicate that only one of each type of minor procedure or diagnostic test listed is payable per patient per day.

Important: Financial adjustments to your LFP claims February 1–3

Setting up a new payment model and the systems to support it is a monumental undertaking. Despite best efforts, there was an error that could affect your claims for February 1–3 dates of service. The LFP Payment Model claims submitted with those dates of service will not be adjudicated as per the usual process on the February 15 remittance.

To ensure physicians are receiving timely payment, these payments will be issued as a lump sum payment for the full dollar amount of any claims billed for February 1–3 dates of service. These will be noted with adjustment code “CL”.

This lump sum payment will be reversed under adjustment code “CM”, as the claims for each separate interaction code will be processed and adjudicated properly, and you will receive a more fulsome report with the individual items paid and listed on your February 28, 2023, remittance.

The definitions of the adjustment codes are:

CL: LFP ADVANCE PAYMENT (+) (i.e., payment total will be as claimed)
CM: LFP ADVANCE RECOVERY (-) (i.e., debit of advance payment amount)

Any claims submitted with dates of service after February 3 (the last MSP cutoff date) are not expected to be impacted.

For questions around any adjustments, please contact Health Insurance BC (HIBC) by calling 604 456-6950 (in Vancouver) or 1 866-456-6950 (toll-free).

LFP Payment Model tools and resources

The LFP Payment Schedule changes are reflected in the LFP Payment Model resources available on the BC Family Doctors website. Updates to the billing resources are happening daily, and new billing tools are being created in response to physician needs. These include a one-page cheat sheet about patient interaction codes that we are making available to all physicians to help guide your daily billing.

The interactive Simplified LFP Guide provides clear, plain-language information about the LFP Payment Model based on the LFP Payment Schedule and our ongoing conversations with government.

Far more than frequently asked questions, the Billing Question Library has detailed information on all areas of billing under the LFP Payment Model and fee-for-service. From included services to cryotherapy to billing for multiple immunizations, there are more than 100 detailed LFP billing questions and hundreds of fee-for-service questions.

If you are not yet a member, you can join BC Family Doctors at any time.

While detailed billing information is hosted on the BC Family Doctors website, the Doctors of BC website is also being continuously updated with the latest information.

New supports for group practices

Business Pathways has created template agreements for group practices, including:

Contractor agreements
Cost Sharing agreements
Release of Information agreements (related to Assignment of Payment)
Group Governance agreements (coming soon)

These templates can be used to minimize the cost of drafting each agreement; however, each clinic will be required to negotiate the terms of their specific agreement using legal support.

Examples used in previous agreements are also available to help physicians with important considerations, such as ensuring a transparent process, and communicating the importance of equal participation by all group members.

To support clinic owners and associate physicians to have transparent and ongoing conversations about business decisions, Business Pathways is continuing to develop new resources to support these conversations, including A Guide to Cost Sharing Agreements.

Need more information?

Write us

Email: LFP.Billing@doctorsofbc.ca

View our information online (member login required)

Doctors of BC: doctorsofbc.ca/new-payment-model
BC Family Doctors: https://bcfamilydocs.ca/lfp-payment-model/
BC Government website: gov.bc.ca/MSP/LFP (login not required)