Ontario doctors may not be paid for telemedicine until July

Health Minister Christine Elliot’s office said in a statement that new billing codes were introduced for over-the-phone care in mid-March so that doctors and patients could comply with physical distancing rules.

Her office said that they’ve seen a “considerable uptake, demonstrating a clear need” for telemedicine. But doctors say the province's billing system has not yet added the new codes.

“Recognizing the need to compensate doctors for this work, the province expects to be ready to start processing claims in early June,” the statement read.

Partly due to a shortage of personal protective equipment, Dr. Nili Kaplan-Myrth has switched most of her office in central Ottawa over to telemedicine.

“My colleagues in my family health group and other family doctors across Ontario are scared because we don't know how we can continue to provide the quality care that we are so committed to and survive financially,” Kaplan-Myrth said.

“We are being asked to work, to see all of our patients, to manage the front line in the community and we're not being paid for it.”

Kaplan-Myrth said she’s checking on coronavirus patients over the phone every day or two and helping manage her own patients' chronic illnesses.

She added that she is able to bill just over $250 for the small number of in-person visits she’s made over the last month but she still has to pay her staff along with her own bills and rent.

Family health groups remain operational based entirely on payments they receive for their services while other practices can receive funding depending on the amount of patients that are registered with them.

Ontario Medical Association (OMA) president, Sohail Gandhi called the delays “inappropriate” and said if claims are not processed until June, payments likely will not be made to physicians until July.

“You just can't tell small businesses… that there's no payment for three months,” Gandhi said.

“That money goes to pay for nurses, it goes to pay for overhead, it goes to pay for receptionists and you can't put those people out.”

Gandhi added that the OMA is communicating with the Ministry of Health to figure out a way to get the payments to physicians. He said the proposed solutions could not be disclosed.

“We really need the bureaucrats to do the right thing here,” Gandhi said.

“If there is an urgent care clinic and if it's not viable and if it goes under, when we start to see a recovery, the patients will have no place to go but the emergency department. That's just going to put an incredible stress on our health-care system. We don't want to be in a situation like that.”

The Orleans Urgent Care Clinic is now taking telemedicine calls and saw a drop of 66 percent in office visits last month.

Dr. Raymond Aubin, the clinic's president of medical associates, said that 150 to 170 patients are usually seen by the clinic on a daily basis—helping to take some of the load off of emergency rooms.

“We expect the volume will pick back up eventually but we have this existential threat,” Aubin said.

He said the clinic has dropped from five doctors to two with a third on call. They have also had to secure a rent deferral due to lost revenues.

Aubin added that despite those measures, there will still be a monthly deficit of $30,000 with no additional government funds.