The Forms Committee is Listening…

The OMA Forms Committee advocates on behalf of physicians to reduce the amount of onerous and unnecessary paperwork. In consultation with OMA Sections, Assemblies, Committees, and individual members the Committee provides recommendations on specific forms to improve both the physician and patient experience. Forms reviewed by the Committee originate from both the federal and provincial governments, their agencies, insurance companies, third parties, and individual physicians.

The members of the OMA Forms Committee are:

• Dr. Scott Elliott, Chair (Family Medicine)
• Dr. Ken Arnold (Family Medicine)
• Dr. Debbie Dyke (Family Medicine)
• Dr. Jane Purvis (Rheumatology)

The mandate of the Committee includes:

• advise on policies that will reduce the amount of administrative burden on physicians
• review existing forms to determine those that can be modernized, modified, or eliminated
• review new and revised forms intended to be completed by physicians
• standardize forms to help make them easier to complete

Recent Committee Activity

The Committee has reviewed forms from the Ministry of Health, Transportation, Children Community and Social Services as well as from several individual agencies. We recently surveyed members on the requirements of specific forms used for requesting consultations. Given our mandate to reduce the numbers and simplify forms, the committee was alarmed by the increased number and complexity of unique forms being produced by some consultants.

Many physicians expressed concerns that the referral process did not conform to the CPSO’s policy. The referral note (irrespective of the form used) must include the information necessary for the consultant physician to understand the questions/issues being asked. Physicians must use their professional judgment to determine the information to be included in the referral request, the CPSO notes that this would typically include:

• Patient, referring physician, and primary care provider identifying information (if different)
• Reason(s) for the consultation and any information being sought or questions being asked
• The referring physician’s sense of the urgency of the consultation
• Summary of the patient’s relevant medical history, including medication information and the results of relevant tests and procedures.

If the nature of the patient’s condition requires an urgent consultation, CPSO suggests that a verbal request for referral may be appropriate, although it must be followed by a written request. Access further details on the relevant CPSO’s policy on referrals.

The Committee thanks those members who contributed to the survey and welcomes your feedback and comments on any of the information contained in this article. For more information please visit the Forms Committee web page.

Most Commonly Used Forms for Patient Care

A mandate of the Forms Committee is to review existing forms to determine those that can be modernized, eliminated or modified. For ease of reference, we have categorized the most commonly used forms for patient care into 5 categories: 

1. OHIP Insured Forms  

The April 1, 2020 OHIP Schedule of Benefits for Physician Services lists numerous forms that are insured under the provincial health plan. 

2. Uninsured forms billable to OHIP  

The OHIP Schedule of Benefits lists forms in Appendix F that are uninsured but billable to OHIP. The services in Appendix F are not “insured services” within the meaning of the Health Insurance Act, but are paid by the MOH, acting as a paying agent. Physicians can submit claims through OHIP using the following fee codes summarized in this table: 

3. Unremunerated forms  

There are various forms that we are required by legislation to complete, which may not be charged to the patient, and may not be submitted to OHIP for payment. Section 24 of the Health Insurance Act R.R.O. 1990, Regulation 552 Amended to O. Reg. 352/04 stipulates what is considered an “uninsured” service and what cannot be submitted to OHIP for payment. Examples:  

• Application for Accessible Parking Permit (002-SR-LV-129E) 
• Eligibility transit application forms  
• Children’s Aid Society forms (on behalf of a child) 
• Ministry of Health forms (e.g. Request for an Unlisted Drug Product (4406-87), ADP Assistive Device forms)   

4. Uninsured and Third-party forms – billable to patients or a third-party

The OMA Uninsured Services Committee maintains a guide for physicians with advice on billing for uninsured and third-party services. The following table extracted from 2020 Physicians Guide to Uninsured Services highlights some examples of uninsured forms: 

Note: [1] The fee for a sick note ($20.00) is intended to be a brief note that confirms diagnosis and/or duration of time off/needed. Fitness to work represents a more comprehensive service that might require a detailed explanation about a patient’s current capabilities and ongoing management, in the context of being fit for employment. 

5. WSIB forms

The Workplace Safety and Insurance Board (WSIB) provides an up-to-date listing of forms and fees in its Physician Fee Schedule. An increase of 1.9% was applied to the existing fee-for-service rates for ten of Ontario’s regulated health professions to existing fee schedules. Visit wsib.ca for details on physician fees.