| Specialty/ Practitioner Type : |
Region Where Services Under Review Provided : |
Region Where Provider Currently Practicing (as of 07/31/01) : |
Period of Review : mm/dd/yy |
Referred to Review Committee |
Contained in Review Committee Decision |
Recovery Amount * : |
| Family Practice and General Practice |
Central West |
Central West |
05/01/96 to 02/28/97 |
A007, K013, W001, W002, W003, W008, W102 |
A007, K013, W001, W008 |
$3,567.37 |
| Cardiology |
Central West |
Central West |
01/01/97 to 12/31/98 |
A603, A604, A605 |
A603, A604, A605 |
$52,865.37 |
| Family Practice and General Practice |
Central East |
Central East |
05/01/96 to 07/31/96 |
A001, A004, A007, A994, A995, G467, G700, K007, K013 |
A001, A004, A007, A994, A995, G467, K007, K013, |
$10,625.00 |
| Internal Medicine |
Central South |
Central South |
05/01/96 to 04/30/98 |
A133, A134, A135 |
A133, A134, A135 |
$105,837.80 |
| Internal Medicine |
Central South |
Central South |
05/01/97 to 04/30/99 |
A135, A136 |
A135, A136 |
$110,000.00 |
| Paediatrics |
Central East |
Central East |
05/01/96 to 09/30/96 |
A007, A263, A264, A265, A266, K013 |
A263, A264, A266 |
$8,333.33 |
| Psychiatry |
Central West |
Central West |
09/01/96 to 08/31/98 |
A994, A995, K002, K003, K190, K195, K197 |
A994, A995, K003, K190, K197 |
$201,352.53 |
| Gastroenterology |
Central East |
Central East |
04/01/97 to 03/31/99 |
A413, A414, A415, K994, K995 |
A413, A414, A415, K994, K995 |
$34,557.30 |
| Family Practice and General Practice |
Central South |
Central South |
05/01/96 to 11/30/96 |
A003, A004, A007, K007, K013 |
A003, A004, A007, K007, K013 |
$2,208.91 |
| Cardiology |
Central West |
Central West |
05/01/96 to 04/30/98 |
A603, A604 |
A603, A604 |
$30,489.44 |
* The recovery amount includes amounts that pertain to services provided on or after May 1, 1996.
|
The Medical Review Committee cases noted above involve the referral of 71 different codes for review. However, it should be noted that of the codes referred for review, some codes were referred much more frequently than other codes. Codes that were more commonly referred include the following :
| Code : |
Description : |
Percentage of Referrals from Cases Noted Above : |
| A007 |
Intermediate Assessment/Well Baby Care |
57% |
| K013 |
Psychotherapy – counseling |
33% |
| A003 |
General Assessment |
30% |
| K007 |
Psychotherapy – individual care |
23% |
| A004 |
General Re-assessment |
17% |
| A133 |
General Assessment |
17% |
| A135 |
Consultation |
17% |
Providers who have questions about claims for a given service are encouraged to contact their District Office and obtain clarification in writing.
More information about the review committee process is contained on the ministry’s website: http://www.health.gov.on.ca
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