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INFOBulletin

Keeping Health Care Providers informed of payment, policy or program changes

Physician Services InfoBulletins

To: Physicians

Published by:Health Services Branch, Ministry of Health and Long-Term Care

Date Issued: December 5, 2017

Bulletin Number: 4705

Re: Echocardiogram Payment Eligibility and Accreditation

Posted Electronically Only

PDF Version Portable Document Format | 1 Mb | 


This INFOBulletin provides the following:

  • an update to the CorHealth Ontario Echocardiography Quality Improvement Program (EQIP) accreditation process; and
  • a reminder of existing payment requirements to physicians who perform and interpret echocardiograms.

Echocardiography Quality Improvement Program (EQIP) Update

CorHealth Ontario has worked closely with the Ministry of Health and Long-Term Care (the ministry) as well as the Ontario Association of Cardiologists to develop an EQIP facility agreement that clearly outlines the accreditation process, including, but not limited to, the following:

  • How CorHealth Ontario assesses your facility;
  • How personal health information within your echocardiography records and images will be used and protected, in alignment with the Personal Health Information Protection Act;
  • How accredited sonographers and physicians lead the accreditation process;
  • How quality improvements identified in the accreditation process (if any) are documented, and monitored;
  • How results of the accreditation process are shared with the ministry; and
  • How a facility may appeal the findings of the EQIP accreditation process, if required.

Once a signed facility agreement is received by CorHealth Ontario, a member of the EQIP team will contact you to schedule a date for a site visit to your facility.

To date, more than 300 echocardiography facilities have begun the EQIP accreditation process with nearly half of these facilities having completed the process and achieved the standards.

For those new or existing facilities who have not yet begun the process, an initial requirement is for each facility to return a signed facility agreement to CorHealth Ontario. This agreement ensures that the participating facility is fully aware of the policies and protocols associated with the accreditation process, and is prepared to begin. To obtain a copy of the revised agreement, visit ccnecho.ca.

Echocardiography Physician Payment Eligibility

Effective April 1, 2016, requirements were added to the Schedule of Benefits for Physician Services that must be met in order for echocardiography services to be eligible for payment.

For further details, please refer to INFOBulletin #4657, posted September 14, 2015, which describes the accreditation requirements.

Note: The EQIP accreditation requirement does not currently apply when physicians provide services in facilities exclusively to patients aged 17 years or younger, or for perioperative transesophageal echocardiograms. Where physicians provide echocardiogram services at the same facility to both adults and individuals aged 17 years or younger, the physician must ensure that the facility meets the new payment requirements for adult echocardiogram services.

  1. Facilities that have registered for the CorHealth Ontario EQIP must be actively involved in completing the accreditation process. Active participation is defined by the parameters of the EQIP and includes submission of all required documentation, including but not limited to the facility agreement.
  2. CorHealth Ontario will notify the ministry if a clinic is not actively participating in the EQIP. This will, in turn, affect payment eligibility of the interpreting physician.
  3. Facilities that are accredited will need to advise the CorHealth Ontario EQIP and the ministry if a new physician providing services has joined the facility. The new physician must fill out and submit form 014-0864-84, “Authorization for Group Payment” (found at http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/FormDetail?openform&ENV=WWE&NO=014-0864-84) in order to be registered with the group number assigned to the facility. New physicians providing insured echocardiogram services at a facility that has been accredited will be required to submit documentation to the EQIP for review, within a specified time frame.
  4. Facilities that are accredited will need to advise the EQIP if a new site is added. Information regarding the new site will need to be submitted to the EQIP for review and subsequent ministry notification, before the physicians are eligible for payment for insured services at the new site.
  5. Physicians performing echocardiograms on individuals aged 17 years of age or less may submit their claims with or without a group number.
  6. Physicians performing fetal echocardiograms that require registration assistance should contact ProviderRegistration.MOH@ontario.ca.

Background

In 2016, the Cardiac Care Network of Ontario and the Ontario Stroke Network merged to form one organization, with a mandate spanning cardiac, stroke and vascular care in the province.  On June 22, 2017, after a year of transition, the new entity became CorHealth Ontario. For more information, visit corhealthontario.ca.

For questions about the EQIP, please contact CorHealth Ontario at (416) 512-7472 or EQI@corhealthontario.ca.  Facility agreements and an up-to-date list of accredited facilities can be found at www.ccnecho.ca.

If you have questions about physician billing eligibility for claims submission/payment and/or a group billing number, please consult http://www.health.gov.on.ca/en/pro/publications/ohip/ohip_billing.aspx

Physicians without access to the internet can contact ServiceOntario at 1-800-668-9938.



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