Text Size

Medical Claims History

Purpose

Under the Medical Care Plan (MCP) Release of Information Program, a beneficiary (patient who receives services paid for by Medical Care Plan (MCP)) can acquire a listing of their medical claims history information for purposes such as: insurance; legal proceedings; or income tax.

^ Top of Page

Information Available

Medical claims history information is available for:

  • Medical Care Plan (MCP) claims submitted by in-province fee-for-service physicians (i.e. physicians in private practice in Newfoundland and Labrador); and
  • Medical Care Plan (MCP) claims submitted by out-of-province fee-for-service physicians.

All history reports identify the patient’s name and Medical Care Plan (MCP) number.

In-province claims history information is available from 1996 onwards. The report contains:

  • the date of service
  • the name and specialty of the physician who rendered the service
  • the type of service rendered (i.e. office visit, x-ray procedure, surgical procedure, etc.)
  • the amount that Medical Care Plan (MCP) paid for the service.

Out-of-province claims history information is available for the past 18 months only. The report contains:

  • the specialty of the physician who rendered the service
  • the province where the service was rendered
  • the type of service rendered (i.e. office visit, x-ray procedure, surgical procedure, etc.)
  • the amount that Medical Care Plan (MCP) paid for the service.

Information such as physician chart records, medical test results and services provided by salaried physicians (i.e. physicians working in hospitals in Newfoundland and Labrador) is not available. Medical Care Plan (MCP) does not usually release detailed diagnostic information, however, when presented with a Court Order (Notice of Examination) this information will be provided.

^ Top of Page

Cost of Obtaining Information

Medical Care Plan (MCP) charges a processing fee for all claims history requests.

  • For in-province claims information the fee is $20.00 for one year of history requested plus an additional $5.00 for each additional year of history requested (i.e. $25 for two years, $30 for three years, etc.) up to a maximum of $75.00.
  • For out-of-province claims information the fee is $25.00.
  • For detailed claims information (including diagnostic descriptions) requested through a Court Order the fee is $25.00 per hour (information search fee) plus a $50.00 witness fee (as per the Rules of The Supreme Court).

Payment can be made by cash, cheque or money order. Cheques and money orders must be made payable to the Newfoundland Exchequer Account.

(Note: Fees are waived for persons in receipt of social assistance and senior citizens who have a valid NLPDP drug card.

^ Top of Page

Who Can Obtain Claims History Information

Medical Care Plan (MCP) claims history information can only be released to a beneficiary or their authorized representative.

An authorized representative is anyone who has the written consent of the beneficiary or clear legal authority to act on behalf of the beneficiary.

In the case of a child under the age of 16 years, the custodial parent or guardian may access the child’s claims history. However, once the child reaches 16 years of age the custodial parent or guardian can only access the child’s claims history with the child’s written consent (i.e. when acting as the child’s authorized representative).

^ Top of Page

Proof of Eligibility / Entitlement

All applicants must provide proof of entitlement to the information requested, as follows:

If you are the beneficiary,

  • a photocopy of your Medical Care Plan (MCP) card
  • a photocopy of one piece of identification that contains your signature (i.e. driver’s license).

If you are the custodial parent or guardian,

  • a photocopy of your child’s Medical Care Plan (MCP) card
  • a photocopy of one piece of identification that contains your signature.

If you are an authorized representative,

  • authorization signed by the beneficiary permitting release of the information to you
  • a photocopy of the beneficiary’s Medical Care Plan (MCP) card
  • a photocopy of one piece of identification that contains your signature.

If you are a person representing the beneficiary’s estate,

  • a photocopy of legal documentation identifying you as the next of kin or estate executor
  • a photocopy of the beneficiary’s Medical Care Plan (MCP) card
  • a photocopy of one piece of identification that contains your signature.

^ Top of Page

Applying for Medical Claims History Information

All requests must:

  • Be made in writing.
  • Clearly identify the beneficiary’s full name, date of birth and Medical Care Plan (MCP) number.
  • Specify the exact period for which the claims history information is required.
  • Include the appropriate identification.
  • Include the appropriate payment.

^ Top of Page

Contact Information

All requests should be mailed to:

Program Coordinator
Medical Care Plan (MCP) Release of Information Program
P.O. Box 8700
Confederation Building, West Block
St. John's, NL A1B 4J6
Tel: (709) 758-1506
Facsimile: (709) 758-1575

^ Top of Page

 
Last Updated:
This page and all contents are copyright, Government of Newfoundland and Labrador, all rights reserved.