Billing Canada Insurance

kimt

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HELP I have a patient coming in from Canada and have no idea how we bill to insurance. Does anybody have a resource for me to look into for answers? I would assume I need to use ICD-10 codes but don't know if there are any other stipulations.

ANY help would be appreciate
 

mmaclachlan

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I have always had patients with out of country insurance pay cash for any services. At the very least, your practice management software will not be able to handle the format of a Canadian patient address.
 

mdoyle53

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Concord, NC or Rochester, NY
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Being Canadian by birth and knowing the system, I would collect cash at the front end and provide the information to the patient. Often times the Canadian Health System will pay minimal and hence you will be left with the bill and how to collect. Most Canadians buy supplemental insurance when going out of the country since the payments are ridiculously low
 

dcrossman

Networker
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Bangor, Maine
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I actually ran into this before. For me, we had a patient that was coming to the States to deliver her baby. We had all kinds of questions regarding what to do and this link got me a starting spot.
http://www.hc-sc.gc.ca/hcs-sss/delivery-prestation/ptrole/index-eng.php
I picked the province she was from (ex: New Brunswick) and then looked for something that said, Travel Coverage, or Claims from Outside Country, etc. If all else fails, look for the Contact Us link somewhere on the page. Most people are very friendly and I was transferred around until I found someone to help.
 
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Milwaukee WI
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Canadian embassy

I have never done this, but I would think you could get all the information you need by contacting the Canadian embassy.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 

mitchellde

True Blue
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Columbia, MO
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I would think you would need to collect from the patient. The ICD-10 codes they use are not the same as our ICD-10 CM codes, there is no way for our system to generate a claim they would recognize, and who knows if they would pay it. If they have a required PCP that must generate a referral then you would have to have that and then is the question of why out of country unless it is an emergency while on vacation. But elective out of country, I think I would collect from the patient.
 

mdoyle53

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Concord, NC or Rochester, NY
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I would collect from the patient as it is a different country and collecting after the Canadian insurance pays (if they pay anything at all!!!) will be very difficult.

Contacting an embassy is an absolute waste of time.

You can contact the provincial health insurance but this could be very timely and may afford nothing.

COLLECT THE MONEY UP FRONT
 
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