Benefits review

he Benefits Review committee

would like to relay some important
information that may clarify benefits
for all College employees.

Reimbursement for B.C.
paramedical practitioners:

(chiropractors, physiotherapists,
naturopaths and massage therapists)

Opting out

You have just visited the chiropractor
and been charged $15. You send in
your receipt to Canada Life and they
send you back only $10 (or $8 for
staff). Boy, are you upset! You thought
that Canada Life should pay for any
costs charged for these types of
services. What’s going on, you ask?

Compensation components

To better understand what has
happened, you need to understand how
a practitioner’s compensation is broken
down. An “opted out” practitioner’s
compensation can be broken down into
three components:

INSURED COMPONENTS
(LEGISLATED)

¢ The Provincial Medical Plan (up to
12 visits)

¢ The Legislated User Fee ($10) *

NON-INSURED COMPONENT
¢ Any additional charge

* The provincial government restricts
payment from any extended health
plan to the legislated $10 user fee for
the first 12 visits. After 12 visits, the
extended health plan can pay whatever
is billed, up to the yearly maximum of
your plan.

The government giveth and
they..
So why have some practitioners seen a

need to add to their bill when the user
fee over the past five years has

increased from $5 in 1994, to $7.50 in
1996, to the current level of $10?
Simple math. As the user fee went
up, the MSP reimbursement went down
by an equal amount. As such, the total
compensation from these two sources
has changed little since 1994. Like
most other businesses, these
practitioners cannot afford the
increasing cost of running their
practices without an increase in
revenue. As such, it has become
commonplace to charge an additional
fee — often called an office visit fee.
Unfortunately, this additional fee is not
covered by our extended health plan
and will vary amongst practitioners.

Partial or full opt out

Most practitioners continue to bill
MSP directly on your behalf and will
bill you only for the user fee, plus the
office visit. This is a partial or soft opt
out, and means you only have to
submit for reimbursement to Canada
Life. Some practitioners may bill you
the full amount, requiring you to claim
reimbursement from both MSP and
Canada Life. This is a full or hard opt
out.

Rules to remember

To help Canada Life determine what
they should be paying, your
practitioner needs to clearly state what
the charges are for — is it the user fee,
MSP or the office visit? Once the MSP
maximum has been reached, this
should also be noted, as all charges will
be reimbursed after this point.

Submitted by: Terry Kennedy
Source: Johnstone’s Journal, August
1999

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Informer

The Informer is produced throughout
the school year by the Community
Relations Department of Capilano

College. Your submissions are welcome,

but please be aware that space
limitations may prevent publication.
Material may be
edited for brevity and clarity.
Send all correspondence to:
Shelley Kean, Editor
Informer
Community Relations
Capilano College
2055 Purcell Way
North Vancouver, B.C. V7J 3H5
Tel: 983-7596
Fax: 984-1714
e-mail: skean@capcollege.bc.ca
Deadline for the September issue:
Monday, September 11, 2000
Next issue date is September 22/00