Physicians who treat beneficiaries may submit claims for insured services directly to Medical Care Plan (MCP). Such claims must be in accordance with the established Medical Care Plan (MCP) Medical Payment Schedule (1.2 MB) and will be processed by Medical Care Plan (MCP) against established claim assessment rules.
All providers who wish to bill the Medical Care Plan or the Dental Health Plan must register with Medical Care Plan (MCP) by submitting a completed Provider Registration Form (83 KB). This form can be used for the initial registration, as well as for changes to registration information or re-activation of a previous registration. A guide (36 KB) for completing the form is also available.
Before a physician can be registered with Medical Care Plan (MCP), licensure by the College of Physicians and Surgeons of Newfoundland and Labrador is required. Likewise, dentists must be licensed by the Newfoundland and Labrador Dental Board before being registered with Medical Care Plan (MCP).
Providers who are registered with Medical Care Plan (MCP) will be assigned a billing number which must be recorded on all claims submitted for payment.
Payment of claims is made in accordance with the Medical Care Plan (MCP) Payment Schedule which is established under the Medical Care Insurance Physicians and Fees Regulations. Physician's Fees are established in consultation with the Newfoundland and Labrador Medical Association. Dentist's fees are established in consultation with the Newfoundland and Labrador Dental Association.
Medical Care Plan (MCP) has established 26, two-week processing cycles during the fiscal year for the submission and processing of provider claims. The end of each two-week cycle is marked by a cut-off date, or deadline, for the receipt of claims. Providers can submit claims at any time during a cycle. The list of claim cut-off dates for the upcoming year is distributed to providers through an Medical Care Plan (MCP) Newsletter.
Providers who wish to submit claims electronically must complete and submit an Electronic Billing Application (41.0 KB).
Providers submitting claims to Medical Care Plan (MCP) may use private vendors' billing software, or Medical Care Plan (MCP)'s TeleClaim Software, to prepare and reconcile claims. The software package chosen must use file formats that conform to Medical Care Plan (MCP)'s specifications for electronic file transmissions. In addition, electronic submission will require installation of Medical Care Plan (MCP)'s Medical Care Plan (MCP)Connect / Medical Care Plan (MCP)Subsys software, a communication package which is provided free of charge.
All claims which are accepted for payment will be paid to the provider through electronic bank deposit, on a payday three weeks from the cut-off date. A remittance statement will be produced for each provider that details each claim that was processed and paid. Providers will receive their remittance statements in an electronic format. The list of claim payment dates for the upcoming year is distributed to providers through an Medical Care Plan (MCP) Newsletter. Providers may assign their payments to another provider, group, or hospital by submitting a completed Assignment of Payment Agreement (73.0 KB) to Medical Care Plan (MCP).
When necessary, Medical Care Plan (MCP) publishes and distributes Newsletters to providers. Normally, each Newsletter concerns a specific topic and may or may not be sent to all providers, depending on the relevancy of the issue to certain specialties or groups of providers.Note: all links below are PDFs and will open in a new window.
Payment Schedule Effective June 1, 2013
Revised Alternate Billing System Rates Effective June, 1 2013
|13-06||Fee-for-service General Practice Obstetric Bonus Program||All fee-for-service General Practitioners|
|13-05||Guide to physician payments||All physicians|
|13-04||Canadian Medical Protective Association (CMPA) rebate on 2012 membership fees||All fee for service physicians|
|13-03||Changes to MCP coverage of laser treatment of vascular skin lesions||Laser Skin Surgeons|
|13-02||MCP Policy regarding Patient Recall for Cervical Screening||Fee-for-Service General Practitioners
|13-01||Revised Payments for Category “B” Emergency Department Coverage (105 KB)||Category “B” Emergency Physicians|
|12-05||Holiday Dates for Fee Code 139 – 2013 (79 KB)||Fee-for-Service General Practitioners|
|12-04||Statutory/Civic Holidays – 2013 (77 KB)||All Physicians and Dentists|
|12-03||Claim Submission Deadlines and Payment Dates – 2013 (76 KB)||All Physicians and Dentists|
|12-02||Fee-For-Service General Practice Obstetric Bonus Program (115 KB)||All Fee-For-Services General Practitioners|
|12-01||Canadian Medical Protective Association (CMPA) Rebate on 2011 Membership Fees (63 KB)||All Fee For Service Physicians|
|11-04||Implementation of the New Memorandum of Agreement: Retroactive Payments (69 KB)||All Fee For Service Physicians|
|11-03||Dental Health Program Payment Schedule (65 KB)||All Dentists|
|11-01||Dental Information Manual (DIM) (69 KB)||All Dentists|
|10-02||Dental Payment Schedule 2010(78 KB)||All Fee For Service Dentists|
|09-08||April 1, 2009 Medical Payment Schedule Index (90 KB) April 1, 2009 Medical Payment Schedule Errata(90 KB)||All Physicians|
|09-05||Dental Health Plan Payment Schedule(87 KB)||All Dental Providers|
|09-04||Surgical Dental Payment Schedule(87 KB)||All Dental Providers|
|09-03||Revised Medical Care Plan (MCP) Payment Schedule Effective April 1, 2009 (101KB)||All Physicians|
|09-02||Surgical Dental Payment Schedule(73 KB)||All Dental Providers|
|08-10||Medical Care Plan (MCP) Re-registration(77 KB)||All Providers|
|08-09||Medical Care Plan (MCP) Card - Embossed and Laser Printed Cards(133 KB)||All Providers|
|08-07||On-Call Payment Program Information Manual(71KB)||On-Call Payment Program Physicians|
|08-02||Claims Monitoring System Update(82 KB)||All Fee-for-Service Physicians|
|07-10||Late Claims Policy(87 KB)||All Physicians and Dentists|
|07-02||Physician Information Manual (PIM)(78 KB)||All Physicians|
|06-07||New Audit Process to be Piloted (Claims Monitoring System)(97 KB)||All Fee For Service Physicians|
|06-10||CMS Brochure Q&A October 2006(29 KB)||All Fee For Service Physicians|
|04-03||Paper Claim Submission of Fee-for-Time Codes(113 KB)||All Fee-for-Service Physicians|
|04-04||Merger of Paper and Electronic Fee-for-Time Billing Systems(103 KB)||All Physicians|
|03-04||Physician Medical Audit Program (168 KB)||All Fee-for-Service Physicians|
|01-07||Billing for Patients Referred to Specialists by Nurse Practitioners(KB)||All Fee-For-Service Physicians|
|00-02||Patient Recall for Cervical Screening(16 KB)||All Physicians|
|99-08||Release of Beneficiary Medical Care Plan (MCP) Numbers(3 KB)||All Physicians and Dentists|
|A-3-'98||Claims for Services Rendered in Hospitals/Health Care Centers(3 KB)||All Fee-For-Service Physicians|
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