Notice: Effective March 2020, the Ministry of Health no longer accepts mailed or couriered documents related to application-based programs. Only applications that are sent by email to a ministry-designated account or via fax (705-564-7493) will be accepted. Applications that include electronic signatures (such as, scanned original, electronic device applications, or digital) will be accepted in lieu of original, signed documents.

Overview

The objective of the Physician Outreach Program for General and Family Practitioners is to provide:

  • regularly scheduled primary care outreach clinics to Northern Health Programs (NHP)-funded nursing stations through nursing stations primary care outreach clinics
  • direct, 24-hour emergency physician backup to the nurse/nurse practitioner working in NHP-funded nursing stations through physician telephone backup

Definitions

Primary care clinics

A program where authorized physicians under arrangement with the NHP travel to provide primary care services at NHP-funded nursing stations for up to two clinic days per week.

Physician telephone backup

Authorized physicians under arrangement with NHP provide formal backup by telephone for delegated acts to nurses/nurse practitioners working in NHP nursing stations. The physician(s) provide immediate and direct telephone backup to nurses/nurse practitioners requesting assistance.

When authorized physician(s) are unable to provide immediate and direct back-up to the nurse/nurse practitioner, the nursing station is provided with the name and telephone number of an alternate physician prior to the authorized physicians taking leave of their telephone back-up responsibilities.

Remuneration

Primary care clinics

The fees are either:

  • fee-for-service plus $221.39 honorarium for each day of outreach service
  • stipend of $553.47 plus $221.39 honorarium for each day of outreach service

Physicians are encouraged to bill fee-for-service rather than stipend on days that at least $553.47 can be billed to OHIP.

A day of "outreach service" consists of a maximum of 6 hours (this includes clinic time and travel to and from the physician's normal place of practice). The minimum length of a clinic is 2 hours. Neither the stipend nor the honorarium may be claimed for clinics of less than 2 hours. For less than 6 hours of outreach service (for example, the minimum 2-hour clinic plus travel time) the $553.47 stipend will be pro-rated accordingly while the honorarium remains at $221.39.

When weather conditions cause the early closure of the clinic, please notify NHP immediately. A decision regarding payment for the day will be made based on the circumstances. When a physician is unable to travel to a nursing station/clinic for the purpose of providing an outreach clinic due to poor weather conditions, no payment for stipend or honorarium will be made.

Physician telephone back-up

$332.08 per month per NHP nursing station/clinic covered. This amount may be shared between two or more physicians.

Direct deposit

All payments for services rendered are made by direct bank deposit. A physician must provide a blank, voided cheque to identify their account and enable NHP to set up a direct deposit account.

Alternate payment plans

Alternate Payment Plans (APP) are payment plans through:

  • Family Health Network (FHN)
  • Family Health Group (FHG)
  • Rural and Northern Physician Group Agreements (RNPGA)
  • others

Physicians who are under an APP payment arrangement, or provide care to rostered patients within provincially funded nursing stations, will only be allowed to claim the $221.39 honorarium for each day of outreach service.

Billing

Primary care clinics

For each day of outreach service performed, the nursing station staff must submit to NHP, on behalf of the physician, a "Physician Outreach Program Billing Statement", signed by both the nursing station and the visiting physician. The statement must indicate the total number of outreach hours broken down by outreach clinical care and travel time.

Physician telephone back-up

For each month of service, the physician(s) must submit to NHP a single letter or a "Physician Outreach Program Back-up Services Billing Form" indicating the nursing station being served and requesting payment for authorized back-up services provided.

Accounts

Accounts, including statements of expenses and billing forms, and inquiries must be received by NHP within 90 days of the date of service to be eligible for payment. Claims received after 90 days will not be paid.

NHP is applying stringent examination of billing for stipends and fee-for-service claims. A physician may either bill fee-for-service or stipend on any approved outreach day. However, claiming both types of payment for the same outreach day is prohibited. Note that this does not apply if a physician has provided office or on-call services in their home community prior to providing service at the nursing station. Should instances of inappropriate billing be identified, the information will be referred to the Ministry of Health’s Monitoring and Compliance department for review.

Contact Us

For more information, you can contact the Ministry of Health, Primary Health Care Branch by: