Billing, Fees and Funding Information

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Billing, Fees and Funding Information

Doctors Nova Scotia has compiled a range of information to help members understand the intricacies of medical billing.


In Nova Scotia, the rules surrounding physician billing are negotiated by Doctors Nova Scotia (DNS) and the provincial government. Physician services are covered by Medical Services Insurance (MSI) Programs, which are administered by Medavie Blue Cross on behalf of the Nova Scotia government.

The majority of physician services are covered by the Master Agreement, a formal funding contract between physicians and the government of Nova Scotia. Clinical/academic physicians are paid according to the terms of the Master Clinical/Academic Funding Plan (C/AFP) Contract. Some physicians or groups of physicians, particularly family physicians and regional specialists, may choose to negotiate an Alternative Payment Plan (APP) with the government.

In some cases, physicians may do work that is funded by other agencies, such as the Workers’ Compensation Board, or provide non-insured services (such as filling out life insurance forms or providing some immunizations).

The rules surrounding medical billing are complex. Doctors Nova Scotia works with MSI to clarify billing rules and explain new and updated fees. In cases where physicians feel that fees should be updated, or new fees created, DNS provides support with fee applications.

In some cases, MSI may audit a physician’s billings. Support is available for physicians who have received a pre-payment assessment or a post-payment audit and wish to appeal the results.

Contact

Jessica Moore
Compensation manager, Master Agreement and Fee Schedule
902-481-4922
1-800-563-3427 ext. 4922