FSCO provides direction for billing when insured changes health practitioners under MIG

The Financial Services Commission of Ontario (FSCO) has provided direction for billing practices when a claimant changes health practitioners within the Minor Injury Guideline (MIG).The regulator also provided direction on the integration of extended health care benefits with the MIG.In a bulletin, FSCO explains that the first practitioner often bills for the entire block amount for treatments leaving the claimant with no funds for additional treatment under that block with their new practitioner.”To address this issue the MIG has been amended to provide that where a claimant changes health practitioners, the first health practitioner may only bill 25% of the amount otherwise payable for a block for each week or part week in which that health practitioner provided treatment under the block,” the bulletin says.FSCO also received inquiries regarding extended health care benefits (EHCB) payments under the MIG. “The SABS rule regarding EHCB carriers as first payers has not changed; therefore benefits covered by EHCB must first be exhausted,” the bulletin says.”However, amounts covered by other sources do not reduce the overall $3,500 cap for medical and rehabilitation benefits.”