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Ontario Health Insurance Plan

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Primary Health Care Services InfoBulletins

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

To:  Rural and Northern Physician Group Agreement (RNPGA) Physicians

Published by:  Negotiations Branch

Date Issued:  January 12, 2017

Bulletin Number:  11164

Re:  Payment of 2016 Seasonal Premium – RNPGA

Posted Electronically Only

PDF Version Portable Document Format | 121 Kb


Issue

Seasonal Premiums were not paid for claims processed by the ministry between July 1 and September 7, 2016.

Background

Per the Rural and Northern Physician Group (RNPGA) agreement, RNPGA physicians are eligible for a Seasonal Premium for services provided in the emergency department a public hospital during the months of the July and August.

When claims are submitted using the RNPGA group number with services dates within the Seasonal Premium period (July and August), they are assessed by the ministry's payment system and the premium is calculated and paid on a group's remittance advice (RA).

What You Need to Know

No action is required for claims you have previously submitted.

Claims that were eligible for the Seasonal Premium (services dates in July and August), that were originally processed by the ministry between July 1st and September 7th 2016, have been reprocessed. The Seasonal Premium payment for these claims will be paid on the February 2017 RA. RA reporting of the Seasonal Premium is located in the Premium Payments Report.

Any outstanding claims for services should be submitted in adherence with the ministry’s stale date policy. Services processed by the ministry after September 7, 2016 for eligible services in the July and August Seasonal Premium period have been assessed and paid correctly.

For any inquiries please contact the Service Support Contact Centre at 1-800-262-6524.


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