To optimize our central intake and referral process please include ALL required information outlined in the checklist:

Similar documents
Guide to OHIP billing for E-Consultation Services for Referring Physicians (K738)

2012 Physician Services Agreement Primary Care Changes

OHIP Payments for E-Consultation Services for Referring Physicians (K738) Quick Reference Guide

Community Care Access Centre

Acquired Brain Injury

Physician s Guide to OHIP billing for Palliative Care Services

Changes to Managed Entry

Periodic Health Examinations: A Rapid Economic Analysis

The Francophone Population

GUIDELINES FOR SCORING INDIVIDUAL RECORDS. Y = Meets Standard N = Does Not Meet Standard. N/A = Not Applicable

A Statistical Anatomy of Ontario Family Physicians Practices Logan McLeod, Gioia Buckley, Arthur Sweetman Abstract (updated January 25, 2016)

FAMILY HEALTH GROUP LETTER OF AGREEMENT. - among-

Primary Care Physician Groups in Ontario.

MH LHIN Palliative Care Initiative. Dr. Robert Sauls September 2010

STATE OF NEW JERSEY DEPARTMENT OF HUMAN SERVICES DIVISION OF MENTAL HEALTH AND ADDICTION SERVICES REQUEST FOR INFORMATION

Ontario Strategy for MRI

Date Issued: September 30, 2014 Bulletin #: Exemption Criteria for Enhanced After-Hours Requirement

Managed Care Referrals and Authorizations (Central Region Products)

State of New Jersey Department of Banking and Insurance

4/17/2017 OBJECTIVES FEDERAL REQUIREMENTS. Having the Difficult Conversation: We need to Discharge You from Hospice

PROVIDER POLICIES & PROCEDURES

New Graduate Entry Program (NGEP) Updated

Sustaining Open Access. Annie Jensen LCSW Clinical Consultant, MTM Services

COMMUNITY MENTAL HEALTH PROGRAM REFERENCE GUIDE

Special Needs Plan (SNP) Model of Care Training 2018

Dietetic Scope of Practice Review

Hamilton Health Sciences Acquired Brain Injury Program

PHYSICIAN ASSISTANT. Controlled Substance Education PHYSICIAN ASSISTANTS

Early and Periodic Screening, Diagnosis, and Treatment Program EPSDT Florida - Sunshine Health Annual Training

Family Medicine Update April Council of Ontario Faculties of Medicine

Blue Choice PPO SM Provider Manual - Preauthorization

Rehabilitation Activation/Restoration Short Term Complex Medical Management Long Term Complex Medical Management

TELECOMMUNICATION SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL

Survey of Ontario Clinics Providing Concussion Services

OHIP Ontario Health Insurance Plan

UNIT DESCRIPTIONS. 2 North Musculoskeletal Rehabilitative Care

After Hours Support for Continuity of Care

Thank you for your request for information regarding the Plan s Appeal Process. You will find the following information to help you with your appeal:

Precertification: Overview

A UNIVERSITY CONSORTIUM RESPONSE TO IEN EDUCATIONAL NEEDS IN ONTARIO

Behavioral Health Initial Review Form

Medical Management Program

Provider Frequently Asked Questions

ATTENDING PHYSICIAN S STATEMENT CRITICAL ILLNESS (TERMINAL ILLNESS)

Passport Advantage (HMO SNP) Model of Care Training (Providers)

French Language Services Alzheimer Society of Peel

OUTPATIENT SERVICES. Components of Service

CLINICAL RESEARCH GRANT #2 (For funding in 2018) CONDITIONS OF AWARD

Having the Difficult Conversation: We need to Discharge You from Hospice

Comprehensive Community Services (CCS) File Review Checklist Comprehensive

Molina Healthcare Michigan Health Care Services Department Phone: (855) Fax: (800)

BHS Policies and Procedures

HOW TO GET SPECIALTY CARE AND REFERRALS

NIA Magellan 1 Medical Specialty Solutions

NEIGHBORHOOD HEALTH PARTNERSHIP POS SUMMARY OF BENEFITS

Section 7: Core clinical headings

ORLANDO EMA HIV/AIDS RYAN WHITE Part A PROGRAM OUTPATIENT/AMBULATORY MEDICAL CARE SERVICE STANDARDS OF CARE

INTEGRATED CASE MANAGEMENT ANNEX A

Shoulder program of care. reference guide OCTOBER 2012

Provider Certification Standards Adult Day Care

Physician Hospital/SNF Collaborative Guidelines

Provider Orientation to Magellan s Outpatient Behavioral Health Model

Date: Illinois Health Connect PCP 6/23/14 Page 1 of 8. Signature:

The University of North Carolina Wilmington PHYSICIAN ASSISTANT COMPETENCY PROFILE

Tuberculosis Prevention and Control Protocol, 2018

RFS-7-62 ATTACHMENT E INDIANA CARE SELECT PROGRAM DESCRIPTION AND COVERED BENEFITS

Aurora Behavioral Health System

Quality Data Model (QDM) Style Guide. QDM (version MAT) for Meaningful Use Stage 2

Coordinated Care Initiative DRAFT Assessment and Care Coordination Standards November 20, 2012

VOTE POLL DETAILS. Polls No.: 1 and 2 Poll No.: 3 Poll No.: 4 Date June 20 June 20 June 20. 9am 12:30pm

Workers Compensation Health Care Network

Chapter 2 Provider Responsibilities Unit 6: Behavioral Health Care Specialists

MEMBER HANDBOOK. Health Net HMO for Raytheon members

Co-creating Care with Ethnic Communities

Behavioral Health Concurrent Review

Care in Your Home. North West CCAC

NATIONAL ACADEMY OF CERTIFIED CARE MANAGERS

Pain: Facility Assessment Checklists

Involuntary Discharge & Involuntary Transfer Packet

Diversity Scholarship 2017

Department of Vermont Health Access Department of Mental Health. dvha.vermont.gov/ vtmedicaid.com/#/home

Behavioral health provider overview

Inpatient Anticoagulation Management Services to Improve Transitions of Care

Mansfield District Hospital. Position Description SPEECH PATHOLOGIST. Page 1 of 9

GPSC Fee Items for A GP For Me/Attachment & In-patient Care

Date of Last Review. Policy applies to Medicaid products offered by health plans operating in the following State(s) Arkansas California

9/13/2016. ASAM Criteria and Levels of Care. Why a Continuum of Care. and. Substance Use. Co-Occurring Disorders. Guiding Principles

Chapter 6: Medical Necessity Criteria Introduction

PacificSource Community Solutions Referral Frequently Asked Questions

UTILIZATION MANAGEMENT AND CARE COORDINATION Section 8

Request for Proposal Pain Management Center of Excellence

Macon County Mental Health Court. Participant Handbook & Participation Agreement

Personal Information Bank (PIB) Details

Regulatory Compliance Risks. September 2009

INFORMATION ABOUT YOUR OXFORD COVERAGE REIMBURSEMENT PART I OXFORD HEALTH PLANS OXFORD HEALTH PLANS (NJ), INC.

Informed Consent for Assessment

CASE MANAGEMENT POLICY

CAH PREPARATION ON-SITE VISIT

Quality on the Frontlines: Coordinating Care Across Sectors and Achieving Better Outcomes

Integrated Behavioral Health Services Austin Travis County Integral Care & CommUnityCare

Transcription:

CPM Patient Referral Checklist To optimize our central intake and referral process please include ALL required information outlined in the checklist: CPM Patient Referral Form see page 3 or you may also use your own referral form. If using your own referral form it must include the below listed information. Please sign and fax the below statement along with your referral: I acknowledge and I agree to resume care for this patient after discharge. Primary Care Practitioner Signature: Cumulative Patient Profile (CPP) Diagnostic Imaging MRT and/or CT Report Date: Medical history and list of medications **Send this if CPP not attached** Relevant consultation, treatments and surgical notes History of substance abuse or addiction Patient demographics Primary Care Practitioner name, demographic and billing number (see note below) Request for Primary Care Practitioner to Physician Telephone Consultation (OHIP Funded Service) Telephone Consultation A service where the referring primary care practitioner requests the opinion and expertise of a CPM physician. It allows the PCP the opportunity to ask questions regarding their patient with chronic pain so they can; a) Continue providing ongoing treatment and/or; b) Refer them to a CPM pain clinic. Refer to page 4 for payment rules and form. IMPORTANT: Did you know that most of our Centres for Pain Management MD s have their Focused Based Practice Designation? This means referring primary care practitioners who belong to a FHT, FHO, FHN and HSO practice model WILL NOT be negated. P: 905.288.1022 TF: 800.265.3429 Ext 1022 F: 905.858.0111 TFF: 877.883.3301 www.cpm-centres.com Last updated December 2017

Dear Primary Care Practitioner, Thank you for referring your patient with chronic pain to one of our CPM centres for assessment and/or treatment. I would like to highlight some of the benefits our centres can offer you and your patients. Centralized Intake Process: We have a Centralized Intake Process to standardize screening of each referral. This process ensures that all required information for the consultation has been received. The efficiency of this process helps us to see your patient on a timelier basis. For specialists, please be advised that CPM will facilitate the co-sign from the patient s primary care physician or nurse practitioner. Timely Assessment of Sub-Acute Pain: The earlier a patient with pain is treated, the more likely a successful outcome will occur. Painful conditions treated within the first 3-6 months using a multimodal approach have the highest chance of full recovery. Patients with pain for more than 18 months can typically expect some reduction in pain and improvement in the quality of life, but it is unlikely their condition will be resolved. We therefore try to prioritize patients with sub-acute pain. Timely Access to Treatments: Our goal is to provide comprehensive, caring, chronic pain management whenever possible. Many components of multidisciplinary care are not funded by OHIP. CPM will provide the Stanford-based, 6-week, Chronic Pain Self-Management Program to all CPM patients at no charge. For patients with supplemental health coverage, we can provide referrals to other elements of comprehensive care: exercise, massage, cognitive-behavioural therapy, and nutrition counselling etc. For patients without coverage we may refer to community and online resources. New patient referrals to CPM will be prioritized based on: a. The need for a one-time consultation vs. a period of active care b. Duration of the painful condition Telephone Consultation: We offer the option of a brief telephone consultation, to better support primary care practitioners (PCPs) whose patients might have to wait to be seen at our centres. This is a funded service in the OHIP Schedule of Benefits both for the referring primary care practitioner and the consulting physician. It is suitable for a patient with chronic pain, where there are a small number of specific questions to help the PCP continue ongoing treatment. A specific 1-page referral form can be sent at your request. You can also request telephone consultation patients currently under the care of a CPM physician. We continually strive to improve our service offerings to referring PCP and patients with pain. Please contact our central intake staff if you have any questions or concerns about referring your patients to CPM. Roman D Jovey MD Medical Director

CPM Centres for Pain Management Referral Form P: 905.288.1022 TF: 800.265.3429 Ext 1022 F: 905.858.0111 TFF: 877.883.3301 www.cpm-centres.com Patient email address if available: Primary Care Practitioner Information: Patient Contact Information: Please check applicable practice model: FHT FHO FHG FHN FFS HSO FHO, FHT will not be negated Are you willing to de-roster your patient? Y N Are you this patient s primary care practitioner? Y N If no, who is the primary care practitioner? Patient Medical Profile Please select the preferred clinic location for your patient Toronto Mississauga Brampton Scarborough Oakville Oshawa London Ottawa Hamilton Specific CPM MD: Medical advice only? Y N Is the primary reason for this referral a request for medical cannabis? Y N Is the primary reason for this referral a patient request for pain infusion? Y N (Available in Oshawa clinic only) Is the primary reason for this referral to request a second opinion? Y N Request for 10 min MD phone conversation? Y N If yes, please complete attached Request for Telephone Consultation form Primary Diagnosis: Length of pain complaint: Has the patient been to a pain clinic? Y N Secondary Diagnosis: History of substance use disorders? Y N If yes, please attach all relevant correspondence To expedite the referral please ensure the following is attached: Copy of your Cumulative Patient Profile (CPP) Relevant imaging Relevant consultation reports List of current medications I acknowledge that I have read the conditions of this referral and I agree to resume care for this patient after discharge. Primary Care Practitioner Signature: Date: P: 905.288.1022 TF: 800.265.3429 Ext 1022 F: 905.858.0111 TFF: 877.883.3301 www.cpm-centres.com Last Updated December 2017

Primary Care Practitioner (PCP) to Physician Telephone Consultation Primary care practitioner to physician telephone consultation is a service where the referring primary care practitioner, in light of his/her professional knowledge of the patient, requests the opinion of another physician (the consultant physician ) by telephone who is competent to give advice in the particular field because of the complexity, seriousness, or obscurity of the case. This service is only eligible for payment if the consultant physician has provided an opinion and/or recommendations for patient treatment and/or management. For the purpose of this service, relevant data include family/patient history, history of the presenting complaint, laboratory and diagnostic tests, where indicated and feasible in the circumstances. Definition/Required elements of service Referring Primary Care Practitioner The referring primary care practitioner initiates the telephone consultation with the intention of continuing the care, treatment and management of the patient. In addition to the Constituent and Common Elements of Insured Services described in the General Preamble of this Schedule, this service includes the transmission of relevant data to the consultant physician and all other services rendered by the referring primary care practitioner to obtain the advice of the consultant physician. Note: This service is eligible for payment in addition to visits or other services provided to the same patient on the same day by the same referring physician. Definition/Required elements of service Consultant physician This service includes all services rendered by the consultant physician to provide opinion/advice/recommendations on patient care, treatment and management to the referring physician or nurse practitioner. The consultant physician is required to review all relevant data provided by the referring primary care practitioner. K730 Physician to PCP telephone consultation Referring PCP... 31.35 K731 Physician to physician telephone consultation Consultant physician... 40.45 Payment rules: 1. A maximum of one K730 service is eligible for payment per patient per day. 2. This service is only eligible for payment for a physician to physician telephone consultation service: a. that includes a minimum of 10 minutes of patient-related discussion for any given patient, and; b. where the referring physician and consultant physician are physically present in Ontario at the time of the service. Medical record requirements: Physician to physician telephone consultation is only eligible for payment where the following elements are included in the medical record for a physician who submits a claim for the service: 1. Patient s name and health number; 2. Start and stop times of the discussion; 3. Name of the referring and consultant physicians; 4. Reason for the consultation, and; 5. The opinion and recommendations of the consultant physician. Claims submission instructions: K731 is only eligible for payment if the consultant physician includes the referring physician s billing number with the claim.

Request for Telephone Consultation Pain Management Primary Care Practitioner Name: OHIP Billing No. Back Line Telephone No. Best time on Tuesday to call: Patient Name: DOB: HCN: Brief history of the pain problem and current treatments (attach additional pages if required): Specific questions to discuss: Date of discussion: Start Stop times: Record of issues discussed / advice given: Billing: - Referring PCP: K730 Consulting MD: K731 Diagnostic Code: Last updated October 2017

CPM Centres for Pain Management Brampton CPM 312 Queen Street East Brampton, ON L6V 1C2 T: 905 458-7377 F: 905 458-7477 Mississauga CPM 6400 Millcreek Drive, Unit #9 Mississauga, ON L5N 3E7 T: 905 288-1045 F: 905 858-0111 Scarborough CPM 1200 Markham Road, Suite #425 Scarborough, ON M1H 3C3 T: 416 438-7080 F: 416 438-7072 Toronto CPM 123 Edward Street, Suite #1118 Toronto, ON M5G 1E2 T: 416 593-7700 F: 416 593-7702 Oshawa CPM 500 King Street West, Unit #2 Oshawa, ON L1J 2K9 T: 905 576-3444 F: 905 576-7980 Oakville CPM 2125 Wyecroft Road, Unit #6 Oakville, ON L6L 5L7 T: 905 842-7051 F: 905 842-8216 London CPM 215 Fanshawe Park Road West, Suite #203 London, ON N6G 5A9 T: 519 434-4727 F: 519 434-4700 Ottawa CPM 550 Terminal Avenue, Unit #B22 Ottawa, ON K1G 0Z3 T: 613 755-2095 F: 613 731-4979 Hamilton CPM 1605 Main Street West Hamilton, ON L8S 1E6 T: 905 574-4911 F: 905 574-8290 AIM Health Group Health and Wellness Centres AIM Toronto 123 Edward Street, Suite #1118 Toronto, ON M5G 1E2 T: 416 593-7700 F: 416 593-7702 AIM Scarborough 1200 Markham Road, Suite #425 Scarborough, ON M1H 3C3 T: 416 438-7080 F: 416 438-7072 AIM Hamilton 1605 Main Street West Hamilton, ON L8S 1E6 T: 905 529-1222 F: 905 529-9855 AIM Kitchener 550 King Street East Kitchener, ON N2G 2L8 T: 519 749-2222 F: 519 749-8937